X-ray, chest (two views)
Facility: Aurora Medical Center
Billing Code: 71046 (CPT)
- CPT Billing Code: 71046
- Insurance Median: $336
- Cash Discount Price: $280
- vs. Medicare Baseline: 3.78x 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 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.
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 - $463 | 225% |
| Aurora Caregiver | $240 | 270% |
| Quartz One | $245 | 276% |
| Common Ground | $249 | 280% |
| Everpointe Elite | $259 | 291% |
| Healthpartners | $266 - $420 | 299% |
| Blue Cross Blue Shield | $275 - $476 | 309% |
| Quartz Group | $290 | 326% |
| Hs Technology | $293 | 330% |
| Wisconsin Physician Service | $299 - $315 | 336% |
| Molina Exchange | $308 | 346% |
| Centivo | $328 | 369% |
| Health Eos Plus | $336 | 378% |
| UnitedHealthcare | $336 - $472 | 378% |
| Health Payment Systems | $400 | 450% |
| Trilogy | $410 | 461% |
| Health Eos | $448 | 504% |
| Cigna | $460 - $474 | 517% |
Consumer Guidance & Cost Commentary
For patients paying out of pocket, the most important takeaway is that the cash rate of $280 is the baseline price for this X-ray procedure at Aurora Medical Center in Grafton, Wisconsin. Because insurance billing involves complex administrative layers and negotiated ceilings, the cash price can sometimes be lower than what an in-network plan would pay, particularly for those with high deductibles. Patients should verify if their specific insurance plan has a negotiated rate that exceeds $280, as paying cash upfront may result in immediate savings compared to the final bill after insurance processing.
The broader financial context shows that while the cash rate is $280, the facility's gross charge is $560, and the median negotiated rate across 18 payers is $336. This procedure is priced at 3.8 times the Medicare benchmark amount of $88.91, which serves as the federally established cost baseline for this service. Although specific county or state average figures were not provided in the available data, the significant markup from the Medicare rate highlights the importance of comparing commercial negotiated rates against this objective standard rather than the facility's full list price.