CMS Price Transparency Data

X-ray, ankle

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $455
  • Cash Discount Price: $310
  • vs. Medicare Baseline: 5.12x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Carilion Stonewall Jackson Hospital is $455. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.12x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$310

Average discount available for prompt cash payment at this facility.

Insurance Median
$455

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: $310 (349%)
Insurance Median: $455 (512%)
Cash: $310 (349% of Medicare)
Ins. Median: $455 (512% 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 512% of the Medicare baseline (a markup of 412%). 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
Blue Cross Blue Shield $33 - $406 37%
Sentara Health Plan $33 - $550 37%
Abh of VA (Formerly Coventry) $34 38%
Abh of Wva (Formerly Coventry) $34 38%
Humana $34 - $83 38%
UnitedHealthcare $34 - $725 38%
Aetna $76 - $589 85%
Gateway - Tier 3 $488 549%
Vhn - Ultra $550 619%
Connecticare $621 698%
Cigna $710 799%
Gateway - Tier 2 $710 799%
Vhn - Plus $710 799%
Integrated Health Plan $754 848%
Vhn $754 848%
Vhn - Link $798 898%
Beech Street $816 918%
Gateway - Tier 1 $843 948%
Vhn - Secondary Payors $843 948%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals