X-ray, chest (single view)
Facility: Phillips County Hospital
Billing Code: 71045 (CPT)
- CPT Billing Code: 71045
- Insurance Median: $213
- Cash Discount Price: $200
- vs. Medicare Baseline: 2.40x 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 240% of the Medicare baseline (a markup of 140%). 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 | $124 - $191 | 139% |
| UnitedHealthcare | $188 - $235 | 211% |
| Health Partners-All Plans | $235 | 264% |
| Medicaid / KanCare | $235 | 264% |
Consumer Guidance & Cost Commentary
For this chest X-ray procedure at Phillips County Hospital, the cash price of $200.00 is lower than the facility's negotiated rates with major payers like UnitedHealthcare ($191.00 median) and Blue Cross Blue Shield ($124.00 to $191.00 range). While the cash price is also below the facility's median negotiated rate of $213.00, it remains significantly higher than the Medicare benchmark of $88.91, which serves as the objective baseline for fair pricing. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance allowed amounts, provided they verify their specific plan's deductible status before scheduling. It is important to note that while the facility is a Critical Access Hospital in Phillipsburg, KS, and owned by the local government, commercial insurance contracts often result in higher final costs due to administrative overhead and contract dynamics.
Patients should be aware that insurance companies negotiate maximum rates to protect members, but these rates can still exceed what a patient would pay out-of-pocket. For instance, Health Partners-All Plans and Medicaid/KanCare have a fixed negotiated rate of $235.00, which is identical to the facility's gross chargemaster price, meaning no discount is applied for these specific plans. To minimize costs, individuals should explicitly ask the hospital for "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can bypass costly insurance billing cycles. Additionally, if a patient receives a bill from an out-of-network provider at this facility, they are protected under the No Surprises Act, which bans balance billing for emergency and non