CMS Price Transparency Data

X-ray, ankle

Facility: Prisma Health Tuomey Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $101
  • Cash Discount Price: $368
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Prisma Health Tuomey Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $368. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.14x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$368

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $368 (414%)
Insurance Median: $101 (114%)
Cash: $368 (414% of Medicare)
Ins. Median: $101 (114% 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.

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 $35 - $87 39%
Humana $37 - $424 42%
Blue Cross Blue Shield $59 - $266 66%
Bluechoice [810] $59 - $265 66%
Scdc-Sc Dept Of Corrections [7232] $62 70%
Cigna $81 - $443 91%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $81 91%
Medicare (plans) $81 - $85 91%
Triwest Healthcare Alliance Vcp [902] $81 91%
Va Community Care Network-Vaccn [903] $81 91%
Tricare $82 92%
UnitedHealthcare $84 - $195 94%
Aetna $85 - $447 96%
Healthy Conn Prime-First Choice Vip Care [5300] $85 96%
Healthy Conn Prime-Molina Healthcare [5330] $85 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $85 96%
Workers Comp [600] $114 128%
Prisma Health Seniorcare Pace - Midlands [5400] $131 147%
Prisma Health Seniorcare Pace-Upstate [5200] $131 147%
Bob Jones Univ-Pai [821] $146 164%
Ambetter / Centene $150 169%
Golden Rule Insurance Company [2991] $195 219%
Oxford Health Plans [2992] $195 219%
Zzumr-Salt Lake City Ut [3169] $195 219%
Promise Health Plan Contracted [2401] $198 - $340 223%
Orangeburg Senior Helping Center Pace [5401] $226 254%
Planned Administrators [820] $266 299%
Meritain Health Contracted [2200] $362 - $447 407%
Preferred Administrators Contracted [2839] $396 445%
Medcost [2940] $419 - $470 471%
Atlantic Packaging Contracted [4833] $424 477%
Aps Healthcare System [2981] $453 510%
Multiplan/Phcs Contracted [2950] $504 567%
Vsp Vision Care [2986] $509 572%
First Health Contracted [2952] $526 592%
Furman Int/Allen University Student [2951] $526 592%
Quiktrip-First Health [3067] $526 592%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals