CMS Price Transparency Data

X-ray, foot

Facility: PAM Specialty Hospital of Wilkes-Barre

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $239
  • Cash Discount Price: $319
  • vs. Medicare Baseline: 2.69x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at PAM Specialty Hospital of Wilkes-Barre is $239. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.69x the Medicare baseline. Located in 575 North River St, Wilkes-Barre, PA.
Cash / Self-Pay
$319

Average discount available for prompt cash payment at this facility.

Insurance Median
$239

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: $319 (359%)
Insurance Median: $239 (269%)
Cash: $319 (359% of Medicare)
Ins. Median: $239 (269% 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 269% of the Medicare baseline (a markup of 169%). 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
America'S Choice $223 251%
Intergroup $239 269%
Provider Network Of Amercia $239 269%
Quik Trip $239 269%
Usa Managed Care Organization $239 269%
Velocity Provider Ppo Network $239 269%
Devon Health Services $255 287%
Multiplan/Phcs $255 287%
Prime Health Services $271 305%
Medincrease $287 323%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 575 North River St, Wilkes-Barre, PA 18764
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL