CMS Price Transparency Data

X-ray, ankle

Facility: Lexington Memorial Hospital Inc

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $162
Cash Discount Price: $184
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Lexington Memorial Hospital Inc is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.82x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$184

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $184 (207%)

Insurance Median: $162 (182%)

Cash: $184 (207% of Medicare)

Ins. Median: $162 (182% 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.

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
Amerihealth	$69 - $101	78%
Carolina Complete	$69	78%
Healthy Blue	$69	78%
Partners	$69	78%
UnitedHealthcare	$70 - $165	79%
Vaya	$70	79%
Wellcare	$70	79%
Alliance	$71	80%
Trillium	$71	80%
Medcost	$81 - $246	91%
Blue Cross Blue Shield	$100 - $160	112%
Aetna	$105 - $340	118%
Ambetter / Centene	$106	119%
Oscar	$118 - $162	133%
Cigna	$160 - $163	180%
Directnet	$217	244%
Healthgram Lexington Home Brands	$265	298%
Healthgram	$294	331%
Private Healthcare Systems	$302	340%
Beechstreet	$324	364%
Humana	$324	364%
Multiplan	$331	372%
National Provider Network	$331	372%

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 $184.
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 Lexington Memorial Hospital Inc 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.