CMS Price Transparency Data

X-ray, foot

Facility: Adena Pike Medical Center

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $533
Cash Discount Price: $354
vs. Medicare Baseline: 5.99x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Adena Pike Medical Center is $533. 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 5.99x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.

Cash / Self-Pay

$354

Average discount available for prompt cash payment at this facility.

Insurance Median

$533

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: $533 (599%)

Cash: $354 (398% of Medicare)

Ins. Median: $533 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Aetna	$170 - $576	191%
Blue Cross Blue Shield	$170 - $610	191%
Buckeye Community Health Plan	$170	191%
Humana	$170 - $672	191%
Medical Mutual Of Ohio	$170 - $449	191%
Medigold	$170	191%
Molina	$170	191%
Care Source	$173	195%
Gateway Health	$233	262%
Molina Marketplace	$278	313%
Care Source Just4Me	$305	343%
Sidecar Health	$467	525%
Ohio Ppo Connect	$495	557%
The Health Plan	$495	557%
Cigna	$512	576%
Medical Mutual Of Ohio Supermed	$533	599%
First Health	$554	623%
Ohio Health Choice	$563	633%
UnitedHealthcare	$608	684%
Integrated Health Plan	$665	748%
Healthsmart	$672	756%
Multiplan/Private Healthcare Systems	$672	756%
Three Rivers Network	$672	756%

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: 73630.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adena Pike Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73630.
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.