CMS Price Transparency Data

X-ray, ankle

Facility: UPMC Kane

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $116
Cash Discount Price: $128
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at UPMC Kane is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.30x the Medicare baseline. Located in 4372 Route 6, Kane, PA.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $128 (144%)

Insurance Median: $116 (130%)

Cash: $128 (144% of Medicare)

Ins. Median: $116 (130% 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.

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 Health Plan	$20 - $148	22%
Blue Cross Blue Shield	$21 - $144	24%
Aetna	$22 - $130	25%
Highmark Wholecare (Prev Gateway)	$22 - $129	25%
UnitedHealthcare	$22 - $166	25%
Amerihealth Caritas	$23 - $135	26%
Geisinger	$31 - $186	35%
PA Health & Wellness	$31 - $186	35%
Horizon Health Plan	$40 - $237	45%
Cigna	$40 - $7,609	45%
Multiplan	$43 - $254	48%
Intergroup	$46 - $270	52%
Health Coalition Partners	$46 - $270	52%
Focus Healthcare	$54 - $321	61%
UPMC Work Partners	$68	76%

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 $128.
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 UPMC Kane 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.