Chest X-ray, 2 views at SSM Health St. Agnes Hospital - Fond du Lac. CPT 71046.
What SSM Health St. Agnes Hospital - Fond du Lac publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$261cash price (self-pay)
$475list price
$64.56–$166range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MOLINA | Medicare Managed Care Plan | $64.56 |
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $64.74 |
| BCBS | Blue Access PPO | $67.02 |
| BCBS | Blue Traditional Traditional | $67.02 |
| BCBS | Anthem Medicare Managed Care Plan | $86.08 |
| Wellcare | Medicare Managed Care Plan | $87.80 |
| DOC | Government | $166 |
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All common services at SSM Health St. Agnes Hospital - Fond du Lac