CMS Price Transparency Data

X-ray, foot

Facility: Holy Cross Hospital - Salt Lake

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $691
Cash Discount Price: $626
vs. Medicare Baseline: 7.77x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Holy Cross Hospital - Salt Lake is $691. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $626. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.77x the Medicare baseline. Located in 1050 East South Temple, Salt Lake City, UT.

Cash / Self-Pay

$626

Average discount available for prompt cash payment at this facility.

Insurance Median

$691

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: $626 (704%)

Insurance Median: $691 (777%)

Cash: $626 (704% of Medicare)

Ins. Median: $691 (777% 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 777% of the Medicare baseline (a markup of 677%). 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
Denver Health	$20	22%
Health Choice	$20	22%
Medicaid / KanCare	$20	22%
Rocky Mountain Health Plan	$20	22%
Uuhp	$20 - $126	22%
Humana	$23	26%
Medicare (plans)	$23	26%
Employer Direct Healthcare	$29	33%
Motivhealth	$31	35%
Molina	$54 - $672	61%
UnitedHealthcare	$71	80%
Blue Cross Blue Shield	$87 - $939	98%
Centura Employee Plan	$91	102%
Cigna	$92 - $1,252	103%
Pehp	$445 - $1,564	501%
Aetna	$461 - $1,322	519%
Wise	$542 - $829	610%
Deseret Mutual Benefit Administrators	$640 - $961	720%
Select Health	$690 - $1,035	776%
Multiplan	$720 - $1,424	810%
Emi Health	$1,043 - $1,564	1173%

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 $626.
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 Holy Cross Hospital - Salt Lake 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.