CMS Price Transparency Data

X-ray, foot

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $297
Cash Discount Price: $210
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Gundersen Moundview Hospital and Clinics is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.34x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$297

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: $210 (236%)

Insurance Median: $297 (334%)

Cash: $210 (236% of Medicare)

Ins. Median: $297 (334% 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 334% of the Medicare baseline (a markup of 234%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerigroup	$24	27%
Blue Cross Blue Shield	$172 - $493	193%
Iowa Total Care	$172	193%
Managed Health Service	$172	193%
Health Partners	$188 - $361	211%
Security Health Plan	$188	211%
Ucare	$188 - $327	211%
Quartz	$223	251%
UnitedHealthcare	$254	286%
Wps	$315	354%
Wps - Arise	$315	354%
Alliance	$327 - $389	368%
Aspirus Arise Health	$339	381%
Humana	$348	391%
Multiplan/Healtheos	$360 - $393	405%
Coventry Health Care	$389	438%
Dean Health Plan	$442	497%

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 $210.
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 Gundersen Moundview Hospital and Clinics 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.