CMS Price Transparency Data

X-ray, ankle

Facility: Children's Hospital of Philadelphia

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $577
Cash Discount Price: $1,373
vs. Medicare Baseline: 6.49x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Children's Hospital of Philadelphia is $577. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,373. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.49x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$1,373

Average discount available for prompt cash payment at this facility.

Insurance Median

$577

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: $1,373 (1544%)

Insurance Median: $577 (649%)

Cash: $1,373 (1544% of Medicare)

Ins. Median: $577 (649% 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 649% of the Medicare baseline (a markup of 549%). 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
Geisinger Medical Assistance	$25	28%
Highmark Wholecare	$28	31%
Horizon Nj Health	$55	62%
Medicaid / KanCare	$227	255%
UnitedHealthcare	$228 - $755	256%
Health Partners	$259	291%
Aetna	$361 - $686	406%
Upmc Medical Assistance	$375	422%
Keystone First Chip	$426	479%
Keystone Health Plan East	$434	488%
Blue Cross Blue Shield	$485 - $550	545%
Geisinger Health Plan Commercial	$604	679%
Jefferson Health Plans	$649	730%
Cigna	$686	772%
Highmark	$686	772%
Qualcare	$755	849%
First Health Network	$892	1003%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$1,098	1235%
Private Health Care Systems	$1,098	1235%
Choice Care Network	$1,236	1390%

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 $1,373.
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 Children's Hospital of Philadelphia 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.