CMS Price Transparency Data

X-ray, ankle

Facility: Hermann Area District Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $216
Cash Discount Price: $224
vs. Medicare Baseline: 2.43x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Hermann Area District Hospital is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.43x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$224

Average discount available for prompt cash payment at this facility.

Insurance Median

$216

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $224 (252%)

Insurance Median: $216 (243%)

Cash: $224 (252% of Medicare)

Ins. Median: $216 (243% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 243% of the Medicare baseline (a markup of 143%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Healthy Blue Mcaid - All Plans	$25	28%
Ambetter / Centene	$26 - $263	29%
Blue Cross Blue Shield	$26 - $304	29%
UnitedHealthcare	$26 - $292	29%
Tricare	$148	166%
Choicecare Mcr Adv- All Plans	$157	177%
American Hlth Mcr Adv- All Plans	$164	184%
Humana	$164	184%
Aetna	$167 - $354	188%
Wellcare Mcr Adv - All Plans	$167	188%
Cigna	$203	228%
Harmony Hp Mcaid- All Plans	$216	243%
Care Partners Mcaid- All Plans	$224	252%
Healthcare Usa Mcaid- All Plans	$242	272%
Healthlink Hmo	$242	272%
Healthlink Ppo - All Other Plans	$280	315%
Multiplan/Phcs - All Plans	$280	315%
Coventry - All Plans	$317	357%
Comp Results - All Plans	$336	378%
Three Rivers - All Plans	$336	378%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $224.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hermann Area District Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.