CMS Price Transparency Data

X-ray, ankle

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $199
Cash Discount Price: $412
vs. Medicare Baseline: 2.24x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Independence Health System Butler Memorial Hospita is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $412. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.24x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$412

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $412 (463%)

Insurance Median: $199 (224%)

Cash: $412 (463% of Medicare)

Ins. Median: $199 (224% 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 224% of the Medicare baseline (a markup of 124%). 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
Upmc	$17 - $824	19%
Ccbh - Behavioral Health	$70 - $392	79%
Aetna	$71 - $628	80%
Pnoa	$71 - $628	80%
Highmark	$73 - $179	82%
Highmark - Ind.& Managed Care	$73 - $199	82%
Highmark Aca - Direct Blue	$73 - $147	82%
Highmark Community Blue	$73 - $175	82%
Workers Comp	$84	94%
Life Butler County	$85	96%
Martin'S Point - Usfhp	$85 - $275	96%
Medicare (plans)	$85	96%
Peak Health	$85 - $550	96%
Provider Partners	$85	96%
Tricare	$85	96%
UnitedHealthcare	$85 - $217	96%
Humana	$88	99%
Amerihealth	$89	100%
Geisinger	$89 - $785	100%
Devoted Health Plan	$90 - $314	101%
The Health Plan	$90 - $199	101%
Pa Health & Wellness	$91	102%
American Health Plan	$93	105%
Gateway	$95 - $824	107%
Ellwood Group	$118 - $338	133%
Cigna	$194 - $392	218%
Private Healthcare Systems	$275 - $667	309%
Devon	$295 - $589	332%
Intergroup	$314 - $628	353%
Multiplan	$354 - $706	398%

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 $412.
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 Independence Health System Butler Memorial Hospita 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.