CMS Price Transparency Data

X-ray, ankle

Facility: Hospital of Univ of Pennsylvania

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $187
  • Cash Discount Price: $467
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Hospital of Univ of Pennsylvania is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.10x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$467

Average discount available for prompt cash payment at this facility.

Insurance Median
$187

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: $467 (525%)
Insurance Median: $187 (210%)
Cash: $467 (525% of Medicare)
Ins. Median: $187 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Medicaid / KanCare $19 - $467 21%
Kaiser Permanente $20 - $467 22%
Keystone Mercy Health Plan $24 - $467 27%
Health Partners $27 - $467 30%
Upmc $28 - $467 31%
Blue Cross Blue Shield $32 - $401 36%
Keystone Hmo Proactive $32 36%
Ibc Commercial Hpn $33 37%
Paired Kidney Exchange $37 42%
UnitedHealthcare $37 - $467 42%
Gspp And Wissahickon Hospice $46 52%
Cigna $77 - $210 87%
Horizon Nj Health $79 - $82 89%
Medicare (plans) $91 - $93 102%
Philadelphia Va Medical Center $91 102%
Tricare $91 102%
Ibc $93 105%
Geisinger Health Plan $94 - $290 106%
Humana $94 - $374 106%
Devoted Health $96 108%
Pa Health And Wellness $96 - $151 108%
Penn Life (Living Independently For Elders) $96 108%
Aetna $97 - $467 109%
Clover Health Plan $99 111%
Keystone First $102 115%
Preferred Health Care Eliance $103 116%
Us Family Health Plan $105 118%
Pgm - Regie De L'Assurance Maladie Quebec $107 120%
Gateway Health Plan $113 127%
Elap $130 146%
Claims Watcher $146 - $165 164%
Oscar Health Plan $156 175%
Pgm - Kuwait Defense $163 - $210 183%
Centivo $165 186%
Elap Services $170 191%
Qualcare $177 199%
Olympus $184 207%
Coventry $187 - $238 210%
Pgm - Chop $187 210%
Wissahickon Hospice $187 210%
Highmark $192 216%
Healthamerica/Coventry $210 - $229 236%
First Health Global $234 263%
Penn Global Medicine $242 272%
Health Net $280 315%
Pgm - Royal Embassy Of Saudi Arabia $280 315%
Pgm - Embassy Of Qatar $304 342%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $304 342%
Interlink $313 352%
Pgm - Embassy Of The United Emirates/Ipc $327 368%
Health America/Ccn $374 421%
Intergroup $374 421%
Pgm - Kuwait Health Division $374 421%
Pgm - Kuwait Oil $374 421%
Preferred Care $374 421%
Blue Quality Centers For Transplant (Bqct) $467 525%
City Of Philadelphia Behavioral Health $467 525%
Commercial Other $467 525%
International Pfs $467 525%
Pa Medical Assistance $467 525%
United Behavioral Health $467 525%
Workers Compensation $467 525%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals