CMS Price Transparency Data

X-ray, ankle

Facility: St Josephs Community Hospital West Bend

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $403
  • Cash Discount Price: $317
  • vs. Medicare Baseline: 4.53x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at St Josephs Community Hospital West Bend is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.53x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$317

Average discount available for prompt cash payment at this facility.

Insurance Median
$403

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: $317 (357%)
Insurance Median: $403 (453%)
Cash: $317 (357% of Medicare)
Ins. Median: $403 (453% 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 453% of the Medicare baseline (a markup of 353%). 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 $48 - $490 54%
Allwell $86 97%
Community Care $86 97%
Health Partners $86 - $374 97%
Humana $86 97%
Icare $86 97%
Molina $86 97%
Network Health Plan $86 - $399 97%
Security Health Plan Secure Savers $86 97%
UnitedHealthcare $86 - $597 97%
Aetna $87 - $403 98%
Care Wisconsin $88 99%
Centivo $173 - $190 195%
Froedtert South $242 272%
Chorus Community Health Plan $248 279%
Common Ground $346 389%
Health Payment Systems $363 - $466 408%
Sheboygan Employers Health Network $426 479%
Wisconsin Physician Services $461 519%
Trilogy $472 531%
Americas Choice $501 563%
Healtheos $501 563%
Multiplan/Private Healthcare Systems $501 563%
First Health Network $507 570%
Hfn $518 583%
Ibsi Passport $518 583%
Cigna $547 615%
Healthsmart $547 615%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals