CMS Price Transparency Data

X-ray, foot

Facility: Lexington Memorial Hospital Inc

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $168
  • Cash Discount Price: $191
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Lexington Memorial Hospital Inc is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.89x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.
Cash / Self-Pay
$191

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $191 (215%)
Insurance Median: $168 (189%)
Cash: $191 (215% of Medicare)
Ins. Median: $168 (189% 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.

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 $72 - $105 81%
Carolina Complete $72 81%
Healthy Blue $72 81%
Partners $72 81%
UnitedHealthcare $72 - $171 81%
Vaya $72 81%
Wellcare $72 81%
Alliance $73 82%
Trillium $74 83%
Medcost $83 - $255 93%
Blue Cross Blue Shield $103 - $165 116%
Aetna $108 - $352 121%
Ambetter / Centene $109 123%
Oscar $122 - $168 137%
Cigna $166 - $169 187%
Directnet $225 253%
Healthgram Lexington Home Brands $274 308%
Healthgram $305 343%
Private Healthcare Systems $312 351%
Beechstreet $335 377%
Humana $335 377%
Multiplan $343 386%
National Provider Network $343 386%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Hospital Drive Po Box 1817, Lexington, NC 27293
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals