X-ray, foot
Facility: Regional Medical Center
Billing Code: 73630 (CPT)
- CPT Billing Code: 73630
- Insurance Median: $870
- Cash Discount Price: $268
- vs. Medicare Baseline: 9.79x 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 979% of the Medicare baseline (a markup of 879%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 979% |
Consumer Guidance & Cost Commentary
For this X-ray of the foot at Regional Medical Center in Manchester, Iowa, the cash price of $268 is notably lower than the facility's gross charge of $335, though the data does not provide a direct comparison to state or county averages. The facility operates as a government-owned Critical Access Hospital with a 4-star rating, and while the Medicare amount for this service is $88.91, commercial insurance from Medical Associates Health Plan - Tri negotiates a rate of $870. Patients with high-deductible plans may find paying the cash price of $268 more financially advantageous than using their insurance, as the commercial negotiated rate significantly exceeds the cash-pay option.
To minimize out-of-pocket costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. It is important to note that while the commercial negotiated rate of $870 serves as a ceiling for in-network coverage, it is inflated by administrative processing costs and contract dynamics, often resulting in higher bills for patients who have not yet met their deductible. If a patient receives a bill based on the full gross charge of $335 or the high negotiated rate, they should request an itemized billing audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through formal written disputes.