CMS Price Transparency Data

X-ray, hand

Facility: St Anthony Community Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73130
  • Insurance Median: $297
  • Cash Discount Price: $1,488
  • vs. Medicare Baseline: 3.34x Medicare
The contracted insurance negotiated median rate for a X-ray, hand at St Anthony Community Hospital is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,488. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.34x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$1,488

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: $1,488 (1674%)
Insurance Median: $297 (334%)
Cash: $1,488 (1674% 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.

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
Emblem $68 - $129 76%
Medicare (plans) $108 - $116 121%
Mvp Gold (McR) $108 121%
Hamaspik (McR) $108 121%
Emblem Select Care (Exchange) $109 123%
Tricare $109 123%
Cigna $114 - $1,042 128%
Affinity By Molina McR $114 128%
Mvp Exchange $122 137%
Emblem Ghi/Hip PPO $128 144%
Blue Cross Blue Shield $165 - $1,019 186%
Self-Pay $183 206%
Mvp Hmo/Ppo $237 267%
Geisinger Health Commercial/Exchange $357 402%
Self-Pay - Cc 30% $446 502%
Aetna $744 837%
Self-Pay - Cc 50% $744 837%
Cdphp $744 837%
PHCS $1,116 1255%
Multiplan $1,116 1255%
Emblem Ghi/Hip Hmo/Epo/Pos $1,190 1338%
Oxford Commercial $1,244 1399%
First Health $1,265 1423%
Magnacare Preferred $1,339 1506%
UnitedHealthcare $1,351 - $1,589 1520%
Oxford Exchange $1,351 1520%
Mvp $15,061 - $17,751 16940%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals