CMS Price Transparency Data

X-ray, foot

Facility: Pennsylvania Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $412
  • Cash Discount Price: $1,085
  • vs. Medicare Baseline: 4.63x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Pennsylvania Hospital is $412. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,085. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.63x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$1,085

Average discount available for prompt cash payment at this facility.

Insurance Median
$412

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: $1,085 (1220%)
Insurance Median: $412 (463%)
Cash: $1,085 (1220% of Medicare)
Ins. Median: $412 (463% 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 463% of the Medicare baseline (a markup of 363%). 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
Gateway Health Plan $12 - $113 13%
Medicaid / KanCare $12 - $1,085 13%
Keystone Mercy Health Plan $15 17%
Upmc $17 - $1,085 19%
UnitedHealthcare $23 - $1,085 26%
Health Partners $27 - $1,085 30%
Blue Cross Blue Shield $32 - $1,085 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 - $868 106%
Aetna $96 - $1,085 108%
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%
Elap $129 145%
Claims Watcher $146 - $164 164%
Oscar Health Plan $155 174%
Centivo $164 184%
Elap Services $169 190%
Horizon Nj Health $183 - $191 206%
Highmark $191 215%
Penn Global Medicine $241 271%
Pgm - Regie De L'Assurance Maladie Quebec $250 281%
Preferred Health Care Eliance $282 317%
Pgm - Kuwait Defense $380 - $488 427%
Devon $412 - $488 463%
Qualcare $412 463%
Coventry $434 - $553 488%
Pgm - Chop $434 488%
Wissahickon Hospice $434 488%
Healthamerica/Coventry $488 - $532 549%
Olympus $527 593%
First Health Global $542 610%
Urn-Cancer Resource Services $542 610%
Health Net $651 732%
Pgm - Royal Embassy Of Saudi Arabia $651 732%
Pgm - Embassy Of Qatar $705 793%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $705 793%
Pgm - Embassy Of The United Emirates/Ipc $760 855%
Devon Health Services Inc $868 976%
Health America/Ccn $868 976%
Intergroup $868 976%
Pgm - Kuwait Health Division $868 976%
Pgm - Kuwait Oil $868 976%
Preferred Care $868 976%
Commercial Other $1,085 1220%
Community Behavioral Health $1,085 1220%
International Pfs $1,085 1220%
Quest Behavioral Health $1,085 1220%
United Behavioral Health $1,085 1220%
Workers Compensation $1,085 1220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals