CMS Price Transparency Data

X-ray, foot

Facility: Tristar Summit Medical Center

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $722
Cash Discount Price: $2,855
vs. Medicare Baseline: 8.12x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Tristar Summit Medical Center is $722. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,855. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 8.12x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$2,855

Average discount available for prompt cash payment at this facility.

Insurance Median

$722

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: $2,855 (3211%)

Insurance Median: $722 (812%)

Cash: $2,855 (3211% of Medicare)

Ins. Median: $722 (812% 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 812% of the Medicare baseline (a markup of 712%). 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
Blue Cross Blue Shield	$21 - $41	24%
Humana	$32 - $2,472	36%
Aetna	$46 - $1,901	52%
Cigna	$83 - $3,042	93%
United	$84 - $1,711	94%
Kentucky Labor Cabinet	$351 - $700	395%
Apex Health	$362 - $722	407%
Nhc Advantage, Inc.	$362 - $722	407%
Pruitt Health (Allyalign)	$362 - $722	407%
Centurion	$786 - $1,567	884%
Bgfh Singlesource	$953 - $3,232	1072%
Multiplan	$1,239 - $2,472	1394%
Employers Health Network	$1,335 - $2,662	1502%
Odom'S Tn Pride Sausage	$1,430 - $2,852	1608%
Compsych	$1,526 - $3,042	1716%
Beech Street	$1,678 - $3,346	1887%
Prime Health	$1,678 - $3,346	1887%

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 $2,855.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Tristar Summit Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73630.
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.