CMS Price Transparency Data

X-ray, foot

Facility: Avita Ontario

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $371
  • Cash Discount Price: $849
  • vs. Medicare Baseline: 4.17x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Avita Ontario is $371. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $849. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.17x the Medicare baseline. Located in 715 Richland Mall, Ontario, OH.
Cash / Self-Pay
$849

Average discount available for prompt cash payment at this facility.

Insurance Median
$371

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: $849 (955%)
Insurance Median: $371 (417%)
Cash: $849 (955% of Medicare)
Ins. Median: $371 (417% 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 417% of the Medicare baseline (a markup of 317%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Caresource $96 108%
Medicaid / KanCare $96 108%
Molina $96 - $5,629 108%
Ohiorise $96 108%
United_Healthcare $96 - $849 108%
Blue Cross Blue Shield $99 - $3,518 111%
Amerihealth $101 114%
Buckeye $104 - $3,518 117%
Humana $104 - $3,518 117%
Aetna $141 - $3,588 159%
Medicare (plans) $141 - $3,518 159%
Mount_Carmel $141 - $3,518 159%
Medical_Mutual $144 - $3,588 162%
Cigna $778 875%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 715 Richland Mall, Ontario, OH 44906
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals