CMS Price Transparency Data

X-ray, chest (two views)

Facility: Decatur Health

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71046
  • Insurance Median: $201
  • Cash Discount Price: $238
  • vs. Medicare Baseline: 2.26x Medicare
The contracted insurance negotiated median rate for a X-ray, chest (two views) at Decatur Health is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.26x the Medicare baseline. Located in 810 W Columbia Street, Oberlin, KS.
Cash / Self-Pay
$238

Average discount available for prompt cash payment at this facility.

Insurance Median
$201

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: $238 (268%)
Insurance Median: $201 (226%)
Cash: $238 (268% of Medicare)
Ins. Median: $201 (226% 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 226% of the Medicare baseline (a markup of 126%). 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 $158 178%
UnitedHealthcare $161 - $201 181%
Humana $163 183%
Blue Cross Blue Shield $194 218%
Aetna $238 - $264 268%
Midlands Choice- All Plans $238 268%
Medicaid / KanCare $267 300%

Consumer Guidance & Cost Commentary

For the CPT code 71046, representing a chest X-ray with two views, Decatur Health in Oberlin, KS, lists a gross charge of $264.00. While the facility's cash median rate is $238.00, commercial insurance payers negotiate rates ranging from $158 to $267 depending on the plan. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; in this case, the highest negotiated rate of $267.00 is actually higher than the cash price. Patients with high-deductible plans may find paying the cash median of $238.00 upfront more cost-effective than relying on insurance, which could result in a higher allowed amount if the deductible has not been met. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.

This service is benchmarked against the federal Medicare rate of $88.91, which serves as a baseline for fair pricing. The facility's cash median of $238.00 represents a significant markup relative to the Medicare amount, a common dynamic where commercial rates can average 200% to 300% of Medicare due to provider cost reports and local wage indexes. To ensure you are receiving the best possible price, we recommend requesting a full itemized billing audit to verify that no unbundled codes or services not rendered have inflated the total. Since over 80% of hospital bills contain errors, reviewing the detailed line items before payment is the most effective way to identify

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