CMS Price Transparency Data

X-ray, chest (single view)

Facility: Tomah Memorial Hospital

Billing Code: 71045 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$35
about 0.4× the $89 Medicare rate · typically $14–$75
modeled estimate · not a bill or quote
Medicare pays $89 Fair price $35 Cash price $93 Hospital's list price $162

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $6 - $198 7%
Blue Cross Blue Shieldmajor $8 - $193 9%
Aetnamajor $9 - $178 10%
Cignamajor $110 - $203 124%
Humanamajor $71 - $194 80%
Quartz $8 - $189 9%
+ 8 smaller / regional plans $8 - $315
Government programs also on file: Military & VA.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 501 Gopher Dr, Tomah, WI 54660
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals