CMS Price Transparency Data

X-ray, ankle

Facility: Oakleaf Surgical Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $86
  • Cash Discount Price: $415
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Oakleaf Surgical Hospital is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$415

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $415 (467%)
Insurance Median: $86 (97%)
Cash: $415 (467% of Medicare)
Ins. Median: $86 (97% 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.

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 $86 97%
Dean Health Plan $86 97%
Group Health Cooperative Of Eau Claire $86 97%
Healthpartners $86 97%
Humana $86 97%
Medica $86 97%
Quartz Health Solutions $86 97%
Security Health Plan Of Wi $86 - $876 97%
Ucare Wi $86 97%
UnitedHealthcare $86 97%
Alliance $216 243%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital in Altoona, Wisconsin, reports a cash median rate of $415 for the X-ray, ankle procedure (CPT 73610). This cash price is notably lower than the facility's gross charge of $461 and significantly below the median negotiated rates of $86 paid by most insurers, with the exception of Security Health Plan Of Wi which paid $876 and Alliance which paid $216. While the cash rate is higher than the Medicare amount of $88.91, patients with high-deductible plans may find it beneficial to pay cash directly, as the negotiated rates from many payers exceed the cash price, potentially resulting in higher out-of-pocket costs for those who rely on insurance coverage.

For patients seeking to minimize costs, it is essential to inquire about "self-pay" or "prompt-pay" discounts before scheduling, as hospitals often offer fee reductions for upfront payments that bypass the administrative overhead of insurance claims processing. Although the data does not provide specific state or county average comparisons for this procedure, the presence of 11 different payers indicates a competitive market where rates vary widely, with Security Health Plan Of Wi's single plan paying $876 and Alliance's single plan paying $216, both substantially higher than the median negotiated rate of $86. Consumers should verify their specific plan's allowed amount and consider requesting a waiver of insurance submission if they intend to pay the cash rate directly to ensure the discount is honored.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals