CMS Price Transparency Data

X-ray, ankle

Facility: Bayshore Medical Center

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $219
Cash Discount Price: $97
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Bayshore Medical Center is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.46x the Medicare baseline. Located in 727 N Beers St, Holmdel, NJ.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$219

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: $97 (109%)

Insurance Median: $219 (246%)

Cash: $97 (109% of Medicare)

Ins. Median: $219 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
UnitedHealthcare	$39 - $219	44%
Amerihealth	$58 - $59	65%
Aetna	$64 - $496	72%
Vaccn	$97	109%
Blue Cross Blue Shield	$97	109%
Wellcare	$97	109%
Cigna	$101 - $506	114%
United Community/Americhoice	$102	115%
Clover	$114	128%
Seoul Medical Group	$118	133%
Oxford	$219	246%
Qualcare	$314 - $557	353%
Horizon	$385 - $546	433%
Bergen Risk	$475	534%
Brighton Health Plan	$506	569%
Multiplan - PHCS	$538	605%

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 $97.
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 Bayshore 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.