CMS Price Transparency Data

X-ray, chest (single view)

Facility: Decatur Health

Billing Code: 71045 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71045
  • Insurance Median: $183
  • Cash Discount Price: $216
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a X-ray, chest (single view) at Decatur Health is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.06x the Medicare baseline. Located in 810 W Columbia Street, Oberlin, KS.
Cash / Self-Pay
$216

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $216 (243%)
Insurance Median: $183 (206%)
Cash: $216 (243% of Medicare)
Ins. Median: $183 (206% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 206% of the Medicare baseline (a markup of 106%). 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.

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
Wppa/Providrs Care- All Plans $144 162%
UnitedHealthcare $147 - $183 165%
Humana $148 166%
Blue Cross Blue Shield $159 179%
Midlands Choice- All Plans $216 243%
Aetna $216 - $240 243%
Medicaid / KanCare $243 273%

Consumer Guidance & Cost Commentary

For the CPT code 71045, representing a chest X-ray (single view), Decatur Health in Oberlin, KS, lists a cash median price of $216.00, which is notably higher than the facility's own cash median of $216.00 and the state average of $216.00. While the facility's negotiated rates for commercial payers range from $144 to $240, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the cash rate is often lower than the commercial negotiated rates charged by insurers like UnitedHealthcare and Aetna. To ensure you receive the best possible rate, it is recommended to explicitly request "self-pay" or "prompt-pay" discounts from the billing department before scheduling your appointment, as these upfront payment incentives can significantly reduce the final amount owed.

When reviewing your bill, it is crucial to request a detailed, itemized statement rather than accepting a summary invoice that obscures individual charges, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. This CPT code has a Medicare benchmark of $88.91, which serves as a scientifically validated baseline for the true cost of care; commercial negotiated rates typically average between 200% and 300% of this Medicare amount, whereas fair pricing is generally defined as 120% to 150%. If you receive a bill that appears inflated, you should dispute any errors in writing to the billing supervisor rather than settling verbally, and avoid paying balance bills immediately without verifying their legality under the No Surprises Act

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 810 W Columbia Street, Oberlin, KS 67749
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals