X-ray, foot
Facility: Oakleaf Surgical Hospital
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $86
- Cash Discount Price: $423
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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
For patients paying out-of-pocket, the cash price for this X-ray procedure at Oakleaf Surgical Hospital in Altoona is $423, which is significantly lower than the facility's gross charge of $470. Because this is a physician-owned acute care hospital, patients should ask specifically about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can eliminate administrative fees and potential balance billing. If you have a high-deductible plan, this direct payment might be more cost-effective than using insurance, especially since the negotiated rate of $86 is lower than the cash price, meaning your insurance would likely cover less than what you would pay directly.
When comparing prices across the region, the facility's cash rate of $423 is notably higher than the state average for this service, though the data provided does not include specific county averages for Altoona. It is important to note that while the facility's gross charge is $470, the actual amount paid by most insurers is capped at $86 due to negotiated contracts, and the Medicare benchmark for this procedure is $88.91. This indicates that the commercial negotiated rate is actually lower than the federal Medicare benchmark, suggesting a favorable price point for insured members compared to the national standard for this specific code.