CMS Price Transparency Data

X-ray, chest (two views)

Facility: Good Samaritan Hospital

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71046
Insurance Median: $406
Cash Discount Price: $2,705
vs. Medicare Baseline: 4.57x Medicare

The contracted insurance negotiated median rate for a X-ray, chest (two views) at Good Samaritan Hospital is $406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,705. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.57x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$2,705

Average discount available for prompt cash payment at this facility.

Insurance Median

$406

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: $2,705 (3042%)

Insurance Median: $406 (457%)

Cash: $2,705 (3042% of Medicare)

Ins. Median: $406 (457% 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 457% of the Medicare baseline (a markup of 357%). 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
Physicians Medical Group	$18	20%
Blue Cross Blue Shield	$20 - $182	22%
Santa Clara Family Health Plan	$21	24%
Cigna	$129 - $2,164	145%
United	$182 - $690	205%
Blue Shield	$212	238%
Medcare Partners	$406	457%
Health Net	$630	709%
Nx Health Network	$1,623	1825%
Sutter Select	$1,623	1825%
Multiplan	$1,758 - $2,164	1977%
Humana	$1,893	2129%
First Health	$2,056 - $2,705	2312%
Healthsmart	$2,164 - $2,299	2434%
Intercontinental Corporation	$2,164	2434%
Pha Pacific Health Alliance	$2,164	2434%
Ppo Next	$2,164	2434%
Aetna	$4,973 - $5,074	5593%

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 $2,705.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71046.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Good Samaritan Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71046.
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.