CMS Price Transparency Data

X-ray, foot

Facility: St Josephs Community Hospital West Bend

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73630
  • Insurance Median: $455
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 5.12x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at St Josephs Community Hospital West Bend is $455. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.12x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$385

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: $385 (433%)
Insurance Median: $455 (512%)
Cash: $385 (433% 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 $44 - $595 49%
Allwell $86 97%
Community Care $86 97%
Health Partners $86 - $455 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 - $490 98%
Care Wisconsin $88 99%
Centivo $210 - $231 236%
Froedtert South $294 331%
Chorus Community Health Plan $301 339%
Common Ground $420 472%
Sheboygan Employers Health Network $426 479%
Health Payment Systems $441 - $566 496%
Wisconsin Physician Services $560 630%
Trilogy $574 646%
Americas Choice $609 685%
Healtheos $609 685%
Multiplan/Private Healthcare Systems $609 685%
First Health Network $616 693%
Hfn $630 709%
Ibsi Passport $630 709%
Cigna $665 748%
Healthsmart $665 748%

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