X-ray, chest (two views)
Facility: Holton Community Hospital
Billing Code: 71046 (CPT)
- CPT Billing Code: 71046
- Insurance Median: $205
- Cash Discount Price: $186
- vs. Medicare Baseline: 2.31x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 231% of the Medicare baseline (a markup of 131%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $131 - $248 | 147% |
| Aetna | $131 - $248 | 147% |
| Humana | $132 | 148% |
| Kansas Superior Select - All Plans | $134 | 151% |
| Preferred Health Fn Select - All Other Plans | $205 | 231% |
| Preferred Health Freedom | $205 | 231% |
| Preferred Health Professionals | $205 | 231% |
| Wppa Providers - All Plans | $235 | 264% |
| Medicaid / KanCare | $248 | 279% |
Consumer Guidance & Cost Commentary
For the CPT code 71046, representing a chest X-ray with two views, Holton Community Hospital in Holton, KS, has a gross charge of $248.00. While the facility's cash median rate is $186.00, which is lower than the negotiated rates paid by most major insurers, patients should be aware that commercial insurance contracts often result in higher allowed amounts. For instance, UnitedHealthcare and Aetna have negotiated rates ranging from $131 to $248, while several other payers, including Preferred Health and Wppa Providers, have fixed negotiated rates of $205 or $235. This illustrates that even though the cash price is lower, insurance plans may cover a significant portion of the cost, potentially leaving the patient with little out-of-pocket expense if their deductible has been met. However, for those with high-deductible plans, paying the cash price of $186.00 upfront could be more cost-effective than facing a negotiated rate that exceeds the cash amount, provided the patient secures a prompt-pay discount before the claim is submitted.
The facility's pricing is benchmarked against the Medicare rate of $88.91, which serves as a baseline for the true cost of care. The cash median of $186.00 represents a markup of 2.3 times the Medicare amount, while the median negotiated rate of $205.00 further increases this cost. Patients should note that balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, but it is crucial to verify network status and request an itemized bill to avoid