CMS Price Transparency Data

X-ray, chest (single view)

Facility: Aurora Medical Center

Billing Code: 71045 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71045
  • Insurance Median: $336
  • Cash Discount Price: $233
  • vs. Medicare Baseline: 3.78x Medicare
The contracted insurance negotiated median rate for a X-ray, chest (single view) at Aurora Medical Center is $336. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.78x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.
Cash / Self-Pay
$233

Average discount available for prompt cash payment at this facility.

Insurance Median
$336

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: $233 (262%)
Insurance Median: $336 (378%)
Cash: $233 (262% of Medicare)
Ins. Median: $336 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Aetna $200 - $384 225%
Aurora Caregiver $240 270%
Quartz One $245 276%
Common Ground $249 280%
Everpointe Elite $259 291%
Healthpartners $266 - $349 299%
Blue Cross Blue Shield $275 - $395 309%
Health Eos Plus $279 314%
Quartz Group $290 326%
Hs Technology $293 330%
Wisconsin Physician Service $299 - $315 336%
Molina Exchange $308 346%
Centivo $328 369%
UnitedHealthcare $336 - $392 378%
Health Eos $372 418%
Cigna $393 - $460 442%
Health Payment Systems $400 450%
Trilogy $410 461%

Consumer Guidance & Cost Commentary

For patients considering self-pay, the most critical information is that the cash median rate for this X-ray service is exactly $233, which represents the average amount billed to those without insurance. While commercial insurance plans typically pay significantly higher amounts due to administrative overhead and contract structures, paying cash upfront can sometimes be the most financially advantageous option, particularly for individuals with high-deductible plans where the insurer's negotiated rate might exceed the cash price. It is essential to contact Aurora Medical Center directly before scheduling to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront fee reductions can further lower the final cost.

Broader rate context reveals that the facility's cash median of $233 is notably lower than the median negotiated rate of $336 and the median paid amount of $282, highlighting the substantial savings potential of direct payment. Furthermore, when compared to the national Medicare benchmark of $88.91, the facility's cash rate is approximately 3.8 times higher, indicating a significant markup relative to the federal government's cost-based calculation. This disparity underscores why commercial rates often appear inflated; while the facility's ownership is a voluntary non-profit, the pricing dynamics for insured patients remain complex, with allowed amounts ranging from $200 to $460 across various payers, making a direct cash payment the most predictable and transparent pricing path.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 Port Washington Road, Grafton, WI 53024
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals