CMS Price Transparency Data

X-ray, ankle

Facility: Novant Health Presbyterian Medical Center

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $206
Cash Discount Price: $244
vs. Medicare Baseline: 2.32x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Novant Health Presbyterian Medical Center is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.32x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$244

Average discount available for prompt cash payment at this facility.

Insurance Median

$206

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: $244 (274%)

Insurance Median: $206 (232%)

Cash: $244 (274% of Medicare)

Ins. Median: $206 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Blue Cross Blue Shield	$27 - $330	30%
Carolina Complete	$72 - $98	81%
Nc Department Of Public Safety	$72 - $169	81%
Amerihealth	$74 - $100	83%
UnitedHealthcare	$74 - $327	83%
Wellcare	$74 - $100	83%
Humana	$85 - $403	96%
Pace Of The Southern Piedmont	$85	96%
Aetna	$87 - $448	98%
Cigna	$87 - $288	98%
Liberty Health	$89	100%
Caresource North Carolina	$137 - $185	154%
Atlantic Corporation Dba Atlantic Packaging	$191 - $258	215%
Amps	$228 - $308	256%
Plotkin Health	$249 - $336	280%
Medcost	$295 - $420	332%
Primary Physician Care	$307 - $414	345%
Multiplan	$311 - $420	350%
Phcs	$311 - $420	350%
Employers Choice Network	$403 - $543	453%
Three Rivers Provider Network	$403 - $543	453%

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 $244.
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 Novant Health Presbyterian Medical Center 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.