X-ray, ankle
Facility: Susan B Allen Memorial Hospital
Billing Code: 73610 (CPT)
- CPT Billing Code: 73610
- Insurance Median: $554
- Cash Discount Price: $125
- vs. Medicare Baseline: 6.23x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 623% of the Medicare baseline (a markup of 523%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 394% |
| Providrs Care | $757 | 851% |
Consumer Guidance & Cost Commentary
For this X-ray of the ankle at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $125.00, which is significantly lower than the facility's negotiated rates of $554.00 and the commercial payer averages of $350.00 to $757.00. While commercial insurance plans like UnitedHealthcare and Providrs Care have negotiated rates that exceed the cash price, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount is higher than the cash rate. It is important to note that commercial rates often include administrative overhead and contract markups that do not apply to cash payments, making the $125.00 self-pay option the most cost-effective choice for this specific service.
The facility's cash rate of $125.00 is also notably lower than the Medicare benchmark of $88.91, though the comparison metric indicates a 6.2% variance relative to the national average for this procedure. Because Medicare rates represent a scientifically validated cost baseline, comparing your potential out-of-pocket costs to this figure helps identify if the facility's pricing is reasonable. If you choose to use insurance, be aware that balance billing could occur if the provider bills the difference between the chargemaster and your insurance allowed amount, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure you receive the best possible rate, we recommend asking the hospital directly about self-pay or prompt-pay discounts before scheduling your visit, as these upfront payment incentives can further reduce your total cost.