X-ray, chest (two views)
Facility: Regional Medical Center
Billing Code: 71046 (CPT)
- CPT Billing Code: 71046
- Insurance Median: $870
- Cash Discount Price: $220
- vs. Medicare Baseline: 9.79x 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 979% of the Medicare baseline (a markup of 879%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 979% |
Consumer Guidance & Cost Commentary
The cash price for this chest X-ray at Regional Medical Center in Manchester, IA, is $220. This rate is notably higher than the facility's own negotiated rate of $870, which is paid by Medical Associates Health Plan - Tri, and significantly exceeds the state average for this procedure. While the facility is a government-owned Critical Access Hospital with a 4-star rating, patients with high-deductible plans should be aware that paying the $220 cash price upfront could be more cost-effective than relying on insurance, as the negotiated rate of $870 far exceeds the cash amount. To minimize costs, patients are encouraged to verify if the hospital offers "self-pay" or "prompt-pay" discounts before scheduling.
This service is billed under CPT code 71046, and the Medicare benchmark amount for this procedure is $88.91. The commercial negotiated rate of $870 represents a substantial markup over the federal baseline, illustrating the common pricing gap between commercial contracts and government rates. Because the allowed amount from the payer is $870, patients must be cautious of balance billing if they receive care from out-of-network providers, though the No Surprises Act protects emergency and non-emergency services at in-network facilities from such unexpected charges. If a discrepancy arises, consumers should request a formal itemized billing audit to identify any unbundled codes or services not rendered, ensuring the final invoice reflects the true cost rather than inflated summary totals.