CMS Price Transparency Data

X-ray, chest (two views)

Facility: Fort Memorial Hospital

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71046
Insurance Median: $68
Cash Discount Price: $89
vs. Medicare Baseline: 0.76x Medicare

The contracted insurance negotiated median rate for a X-ray, chest (two views) at Fort Memorial Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.76x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $89 (100%)

Insurance Median: $68 (76%)

Cash: $89 (100% of Medicare)

Ins. Median: $68 (76% 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
Humana	$10 - $85	11%
Molina	$11 - $85	12%
UnitedHealthcare	$11 - $85	12%
Blue Cross Blue Shield	$23 - $117	26%
Dean Health Plan	$23 - $387	26%
Medicaid / KanCare	$23	26%
Quartz	$23 - $332	26%
Managed Health Services	$25	28%
Aetna	$28 - $363	31%
Fort Care	$33 - $97	37%
Group Health Cooperative	$45 - $313	51%
Alliance	$50 - $347	56%
Mercycare	$52 - $360	58%
Trilogy	$61 - $425	69%
Cigna	$66 - $460	74%
Medicare (plans)	$85	96%
Veteran Evaluation Services	$105	118%
Centivo	$480 - $500	540%

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 $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71046.

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 71046.
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.