CMS Price Transparency Data

X-ray, ankle

Facility: Adena Fayette Medical Center

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $469
Cash Discount Price: $354
vs. Medicare Baseline: 5.27x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Adena Fayette Medical Center is $469. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $354. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.27x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$354

Average discount available for prompt cash payment at this facility.

Insurance Median

$469

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: $354 (398%)

Insurance Median: $469 (527%)

Cash: $354 (398% of Medicare)

Ins. Median: $469 (527% 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 527% of the Medicare baseline (a markup of 427%). 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	$240 - $491	270%
Aetna	$290 - $560	326%
Buckeye Community Health Plan	$290	326%
Humana	$290	326%
Medical Mutual Of Ohio	$290 - $533	326%
Medigold	$290	326%
Molina	$290	326%
Care Source	$296	333%
Molina Marketplace	$319	359%
United Medical Resources Ohcp	$445	501%
UnitedHealthcare	$445 - $449	501%
Cigna	$487	548%
Ohio Ppo Connect	$495	557%
The Health Plan	$495	557%
Care Source Just4Me	$522	587%
Medical Mutual Of Ohio Supermed	$533	599%
First Health	$554	623%
Ohio Health Choice	$563	633%
Multiplan/Private Healthcare Systems	$672	756%
Sidecar Health	$799	899%

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 $354.
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 Adena Fayette 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.