CMS Price Transparency Data

X-ray, chest (two views)

Facility: Adventist Health Clearlake

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71046
Insurance Median: $322
Cash Discount Price: $237
vs. Medicare Baseline: 3.62x Medicare

The contracted insurance negotiated median rate for a X-ray, chest (two views) at Adventist Health Clearlake is $322. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.62x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$237

Average discount available for prompt cash payment at this facility.

Insurance Median

$322

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: $237 (267%)

Insurance Median: $322 (362%)

Cash: $237 (267% of Medicare)

Ins. Median: $322 (362% 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 362% of the Medicare baseline (a markup of 262%). 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
Bc Managed Mcal	$39	44%
Medi-Cal	$39	44%
Blue Shield Mcr Adv	$75 - $171	84%
Kaiser Mcr Adv	$75 - $171	84%
Tricare	$75 - $171	84%
Blue Cross Blue Shield	$78 - $259	88%
UnitedHealthcare	$83 - $680	93%
Ah Employee Health Plan - All Plans	$150 - $342	169%
Blue Shield Epn - All Other Plans	$194	218%
Blue Shield Non-Epn	$204	229%
Aetna	$268 - $609	301%
Western Growers- All Plans	$268 - $611	301%
First Health- All Plans	$286 - $652	322%
Healthnet- All Plans	$294 - $668	331%
Foundation- All Plans	$304 - $693	342%
Health Mgmt Network- All Plans	$304 - $693	342%
Humana	$304 - $693	342%
Phcs- All Plans	$304 - $693	342%
Cigna	$322 - $734	362%
Interplan- All Plans	$322 - $734	362%
Kaiser- All Other Plans	$322 - $734	362%
Three Rivers Provider Network- All Plans	$322 - $734	362%
Partnership Mcal - All Plans	$591 - $1,345	665%

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 $237.
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 Adventist Health Clearlake 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.