CMS Price Transparency Data

X-ray, chest (single view)

Facility: Pali Momi Medical Center

Billing Code: 71045 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71045
Insurance Median: $106
Cash Discount Price: $205
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a X-ray, chest (single view) at Pali Momi Medical Center is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.19x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.

Cash / Self-Pay

$205

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $205 (231%)

Insurance Median: $106 (119%)

Cash: $205 (231% of Medicare)

Ins. Median: $106 (119% 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.

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
Alohacare	$17 - $115	19%
Hmsa	$17 - $104	19%
UnitedHealthcare	$17	19%
Ohana	$18 - $125	20%
Mdx	$26 - $104	29%
Verdegard	$50	56%
Devoted	$110	124%
Pac Admin	$239	269%
Calvos	$256	288%
Mimoh	$256	288%
Hwmg/Hmaa	$257	289%
Hcha	$273	307%
Kaiser	$273	307%
Multiplan	$273 - $290	307%
Coventry	$290	326%
Mccp	$290	326%

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 $205.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71045.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pali Momi Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71045.
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.