CMS Price Transparency Data

X-ray, foot

Facility: Penn Presbyterian Medical Center

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $338
  • Cash Discount Price: $845
  • vs. Medicare Baseline: 3.80x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Penn Presbyterian Medical Center is $338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $845. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.80x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$845

Average discount available for prompt cash payment at this facility.

Insurance Median
$338

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: $845 (950%)
Insurance Median: $338 (380%)
Cash: $845 (950% of Medicare)
Ins. Median: $338 (380% 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 380% of the Medicare baseline (a markup of 280%). 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 $12 - $845 13%
Keystone Mercy Health Plan $15 - $845 17%
Upmc $17 - $845 19%
UnitedHealthcare $23 - $845 26%
Health Partners $27 - $845 30%
Blue Cross Blue Shield $32 - $845 36%
Keystone Hmo Proactive $32 36%
Ibc Commercial Hpn $33 37%
Cigna $71 - $94 80%
Medicare (plans) $91 - $93 102%
Philadelphia Va Medical Center $91 102%
Tricare $91 102%
Ibc $93 105%
Geisinger Health Plan $94 - $289 106%
Humana $94 - $676 106%
Aetna $96 - $845 108%
Pa Health And Wellness $96 - $150 108%
Penn Life (Living Independently For Elders) $96 108%
Clover Health Plan $98 110%
Keystone First $101 114%
Us Family Health Plan $105 118%
Gateway Health Plan $113 127%
Elap $129 145%
Horizon Nj Health $143 - $149 161%
Claims Watcher $146 - $164 164%
Oscar Health Plan $155 174%
Centivo $164 184%
Elap Services $169 190%
Highmark $191 215%
Pgm - Regie De L'Assurance Maladie Quebec $194 218%
Preferred Health Care Eliance $211 237%
Penn Global Medicine $241 271%
Pgm - Kuwait Defense $296 - $380 333%
Devon $321 - $380 361%
Qualcare $321 361%
Coventry $338 - $431 380%
Pgm - Chop $338 380%
Wissahickon Hospice $338 380%
Healthamerica/Coventry $380 - $414 427%
Olympus $401 451%
First Health Global $422 475%
Urn-Cancer Resource Services $422 475%
Health Net $507 570%
Pgm - Royal Embassy Of Saudi Arabia $507 570%
Pgm - Embassy Of Qatar $549 617%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $549 617%
Pgm - Embassy Of The United Emirates/Ipc $592 666%
Devon Health Services Inc $676 760%
Health America/Ccn $676 760%
Intergroup $676 760%
Pgm - Kuwait Health Division $676 760%
Pgm - Kuwait Oil $676 760%
Preferred Care $676 760%
Commercial Other $845 950%
International Pfs $845 950%
Magellan $845 950%
Quest Behavioral Health $845 950%
United Behavioral Health $845 950%
Workers Compensation $845 950%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals