CMS Price Transparency Data

X-ray, chest (two views)

Facility: Nmc Health

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71046
  • Insurance Median: $84
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a X-ray, chest (two views) at Nmc Health is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.94x the Medicare baseline. Located in 600 Medical Center Drive, Newton, KS.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $119 (134%)
Insurance Median: $84 (94%)
Cash: $119 (134% of Medicare)
Ins. Median: $84 (94% 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.

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
Bluestem Pace $30 - $84 34%
Wppa $39 - $148 44%
Occunet $42 - $161 47%
Medincrease Health Plan $46 - $175 52%
Samaritan Ministries International $46 - $175 52%
Leading Age $47 - $134 53%
Medicaid / KanCare $47 - $134 53%
Prime Health Services $53 - $202 60%
Aetna $58 - $222 65%
UnitedHealthcare $63 - $242 71%
Cigna $67 - $256 75%
Blue Cross Blue Shield $151 170%

Consumer Guidance & Cost Commentary

For the CPT code 71046, representing a chest X-ray with two views, Nmc Health in Newton, Kansas, lists a cash median price of $119.00, which is notably lower than the facility's negotiated rates. While the facility's negotiated rate averages $84.00, commercial payers such as Aetna and UnitedHealthcare have allowed amounts ranging from $58 to $242, meaning patients with high-deductible plans might find paying the cash price directly more cost-effective than relying on insurance reimbursement. It is important to note that the facility's cash rate is significantly lower than the gross chargemaster price of $269.00, and patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling to ensure they receive the lowest possible out-of-pocket rate.

When evaluating the cost of this procedure, it is essential to compare the facility's pricing against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this service is $88.91, and the facility's cash rate of $119.00 represents a markup of approximately 1.33 times the Medicare rate, which falls within the range of fair pricing typically defined as 120% to 150% of Medicare. Additionally, the facility's negotiated rate of $84.00 is slightly below the Medicare amount, suggesting a competitive contract structure. For patients concerned about billing accuracy, receiving an itemized bill is critical to identifying any unbundled charges or services not rendered, as summary bills often obscure the true cost of care.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Medical Center Drive, Newton, KS 67114
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals