X-ray, chest (single view)
Facility: Hiawatha Community Hospital
Billing Code: 71045 (CPT)
- CPT Billing Code: 71045
- Insurance Median: $338
- Cash Discount Price: $434
- vs. Medicare Baseline: 3.80x 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 380% of the Medicare baseline (a markup of 280%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $117 - $124 | 132% |
| Aetna | $161 - $351 | 181% |
| UnitedHealthcare | $161 - $373 | 181% |
| Humana | $162 | 182% |
| Ambetter / Centene | $193 | 217% |
| Centrus Health Direct - All Plans | $326 | 367% |
| Oscar - All Plans | $326 | 367% |
| Preferred Hlth - All Plans | $391 | 440% |
| Cigna | $412 | 463% |
| Wppa Providrs Care - All Plans | $412 | 463% |
| Multiplan - All Plans | $421 | 474% |
| Midlands Choice - All Plans | $421 | 474% |
| Healthy Blue Mcaid - All Plans | $434 | 488% |
Consumer Guidance & Cost Commentary
For the CPT code 71045 (X-ray, chest, single view) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $434.00, which matches the facility's gross charge. This cash rate is significantly higher than the state average for this procedure, as the median paid amount across all payers is $195.00. While commercial insurance negotiated rates range from $117 to $434 depending on the plan, patients with high-deductible plans may find paying the full cash price of $434.00 more cost-effective than relying on insurance, which often results in higher out-of-pocket costs if the deductible has not been met. It is important to note that while the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, patients should still verify their specific plan status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full chargemaster rate.
The facility's pricing structure reveals a significant markup compared to the federal Medicare benchmark, with the cash price representing a 3.8x multiplier of the Medicare amount of $88.91. This disparity highlights the importance of using Medicare rates as a baseline for evaluating commercial pricing rather than comparing discounts against inflated list prices. Although the facility is a voluntary non-profit Critical Access Hospital with a facility rating of 3, the wide variance in negotiated rates among the 13 different payers—ranging from $117 for Blue Cross Blue Shield to $434 for Healthy Blue Medicaid—demonstrates that network status does not guarantee the