CMS Price Transparency Data

X-ray, chest (single view)

Facility: Fort Memorial Hospital

Billing Code: 71045 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71045
Insurance Median: $27
Cash Discount Price: $74
vs. Medicare Baseline: 0.30x Medicare

The contracted insurance negotiated median rate for a X-ray, chest (single view) at Fort Memorial Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.30x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$74

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $74 (83%)

Insurance Median: $27 (30%)

Cash: $74 (83% of Medicare)

Ins. Median: $27 (30% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$6 - $85	7%
Dean Health Plan	$7 - $387	8%
Molina	$7 - $85	8%
Quartz	$7 - $256	8%
UnitedHealthcare	$7 - $85	8%
Humana	$8 - $85	9%
Managed Health Services	$8 - $25	9%
Mercycare	$8 - $278	9%
Aetna	$13 - $280	15%
Alliance	$22 - $268	25%
Medicaid / KanCare	$23	26%
Fort Care	$27 - $76	30%
Centivo	$41 - $500	46%
Group Health Cooperative	$51 - $271	57%
Trilogy	$74 - $329	83%
Cigna	$80 - $355	90%
Medicare (plans)	$85	96%
Veteran Evaluation Services	$105	118%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $74.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71045.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fort Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71045.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.