X-ray, chest (two views)
Facility: Hiawatha Community Hospital
Billing Code: 71046 (CPT)
- CPT Billing Code: 71046
- 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 | $143 - $151 | 161% |
| 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% |
| Wppa Providrs Care - All Plans | $412 | 463% |
| Cigna | $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 71046, representing a chest X-ray with two views, Hiawatha Community Hospital in Hiawatha, KS, lists a cash price of $434.00. This cash rate is identical to the facility's negotiated median paid amount of $284.00 and the Medicare benchmark of $88.91. The facility's cash price is 3.8 times higher than the Medicare rate, which serves as the federal baseline for evaluating hospital pricing markups. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that commercial negotiated rates from in-network payers like Aetna and UnitedHealthcare range from $161 to $373, which are significantly higher than the cash price. This pricing dynamic suggests that for patients with high-deductible plans, paying cash directly may result in lower out-of-pocket costs compared to having insurance process the claim, as the negotiated rates exceed the cash-pay amount.
To ensure you are receiving the most accurate pricing, it is essential to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Although the facility offers a prompt-pay discount for upfront payments, which can reduce administrative costs and improve cash flow, patients should verify this offer directly with the hospital prior to scheduling to avoid automatic claims submission that might void the discount. Additionally, while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should remain vigilant regarding any unexpected ancillary charges. Given that the facility is located in