CMS Price Transparency Data

X-ray, foot

Facility: Porter Hospital Inc

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $36
Cash Discount Price: $248
vs. Medicare Baseline: 0.40x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Porter Hospital Inc is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.40x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$248

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $248 (279%)

Insurance Median: $36 (40%)

Cash: $248 (279% of Medicare)

Ins. Median: $36 (40% 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.

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
UnitedHealthcare	$5 - $449	6%
Mvp	$6 - $423	7%
Fidelis Care	$7 - $192	8%
Humana	$7 - $84	8%
Aetna	$8 - $213	9%
Capital District Physicians' Health Plan	$8 - $379	9%
Martins Point	$8 - $213	9%
Veterans Affairs Community Care Network	$8 - $213	9%
Veterans Choice	$8 - $213	9%
Blue Cross Blue Shield	$9 - $427	10%
Harvard Pilgrim	$9 - $363	10%
Coventry	$10 - $400	11%
Cigna	$11 - $413	12%
Wellpath	$23 - $250	26%
Medical Corporation	$40 - $431	45%
Multiplan	$40 - $431	45%

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 $248.
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 Porter Hospital Inc 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.