X-ray, chest (single view)
Facility: Children'S Mercy South
Billing Code: 71045 (CPT)
- CPT Billing Code: 71045
- Insurance Median: $236
- Cash Discount Price: $96
- vs. Medicare Baseline: 2.65x 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 265% of the Medicare baseline (a markup of 165%). 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 |
|---|---|---|
| UnitedHealthcare | $7 - $365 | 8% |
| Medicaid / KanCare | $8 - $57 | 9% |
| Home State Health | $8 - $198 | 9% |
| Cigna | $8 - $377 | 9% |
| Healthy Blue | $8 - $226 | 9% |
| Wppa Providrs Care | $11 - $353 | 12% |
| Healthlink | $11 - $478 | 12% |
| American Healthcare Alliance | $12 - $462 | 13% |
| Health Midwest Comprehensive Care | $12 - $353 | 13% |
| Medica | $15 - $317 | 17% |
| Wellfit/Centrus | $16 - $353 | 18% |
| Blue Cross Blue Shield | $16 - $402 | 18% |
| Centivo | $17 - $353 | 19% |
| Nebraska Furniture Mart | $17 - $353 | 19% |
| Coxhealth Network | $19 - $402 | 21% |
| Mercy Health | $19 - $407 | 21% |
| National Preferred Provider Network | $23 - $489 | 26% |
| Aetna | $217 - $369 | 244% |
| Orscheln | $235 - $353 | 264% |
| Quiktrip | $236 - $353 | 265% |
| Humana | $241 - $361 | 271% |
| Coventry Health Care Of Kansas | $268 - $402 | 301% |
| Multiplan | $275 - $413 | 309% |
Consumer Guidance & Cost Commentary
For CPT code 71045, a chest X-ray, Children's Mercy South in Overland Park charges a gross list price of $199.00. This amount is significantly higher than the facility's cash median of $96.00, which may be the most cost-effective option for patients with high-deductible plans or those without insurance. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Aetna range from $16 to $217, these figures often exceed the cash price due to administrative costs and contract structures. It is important to note that commercial negotiated rates frequently average 200% to 300% of the Medicare benchmark of $88.91, whereas fair pricing is typically defined as 120% to 150% of this baseline. Patients should verify their specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price can lead to unexpected costs if the insurer's negotiated rate is higher than the cash rate.
To minimize potential financial exposure, patients should proactively request "self-pay" or "prompt-pay" discounts from the billing department before check-in, which can reduce the final bill by 20% to 50%. If a balance bill arises from an out-of-network service, such as an emergency physician or lab at an in-network facility, patients should not pay immediately out of fear of credit damage; instead, they should dispute the bill with their insurer and request a No Surprises Act audit. Additionally, patients should demand a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain