CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: San Antonio Regional Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $362
  • Cash Discount Price: $1,243
  • vs. Medicare Baseline: 3.39x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at San Antonio Regional Hospital is $362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.39x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$1,243

Average discount available for prompt cash payment at this facility.

Insurance Median
$362

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,243 (1164%)
Insurance Median: $362 (339%)
Cash: $1,243 (1164% of Medicare)
Ins. Median: $362 (339% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 339% of the Medicare baseline (a markup of 239%). 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
Tricare $132 124%
Blue Shield Mcr Adv $134 125%
Caremore Mcr Adv - All Plans $134 125%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $134 125%
Healthnet Mcr Adv $134 125%
Humana $134 125%
Iehp Mcr Adv $134 125%
Inter Valley Hp Mcr Adv- All Plans $134 125%
Kindred Mcr Adv-All Plans $134 125%
Molina Mcr Adv $134 125%
Scan Health Plan Mcr Adv-All Plans $134 125%
Universal Care - All Plans $134 125%
Blue Cross Blue Shield $137 - $5,262 128%
Zelis Mcr Adv $141 132%
Kasiser Mcr Adv $144 135%
Imperial Health Mcr Adv-All Plans $148 139%
Choice Phycn Ntwrk Op Only $168 157%
Molina Exchange-All Other Plans $175 164%
Aetna $182 - $9,682 170%
Iehp Comm - All Other Plans $195 183%
Redlands Employee $202 189%
Redlands Hmo-All Other Plans $210 197%
Medi-Cal $233 218%
Prime Health - All Plans $235 220%
Kaiser Medi-Cal $245 229%
Healthnet Medi-Cal $246 230%
Alpha Care Mg Mcal/Hlthy Kids $257 241%
Heritage Prov Ntwrk/Regal Mcal $257 241%
Molina Medi-Cal $268 251%
Iehp Mcal $303 284%
UnitedHealthcare $316 - $1,345 296%
Healthnet - All Other Plans $322 301%
Pc Inland Valley Scan $362 339%
Pc Inland Valley-All Other Plans $362 339%
Kaiser Comm - All Other Plans $375 351%
Blue Shield Epn $420 393%
Choicecare Ntwrk-All Plans $550 515%
Coventry Ccn/First Hlth - All Plans $1,200 1123%
Ambetter / Centene $1,762 1650%
Epic Health Plan - All Other Plans $2,905 2720%
Blue Shield Epo Ppo - All Other Plans $3,244 3037%
Blue Shield Hmo Pos / Calpers Ppo $3,244 3037%
Multiplan/Phcs - All Plans $6,971 6527%
Networks By Design - All Plans $7,262 6799%
Zelis Comm-All Other Plans $7,262 6799%
Foundation Inland Epo-All Other Plans $7,746 7252%
Foundation Inland Ppo $8,230 7705%
Health Payors - All Plans $8,714 8158%
Interplan - All Plans $8,714 8158%
Wellcare/Easy Choice-All Plans $9,488 8883%
Alpha Care Mg Mcr Adv $9,682 9065%
Central Hlth Plan Mcr Adv-All Plans $9,682 9065%
Epic Health Plan Mcr Adv $9,682 9065%
Prospect Hp-All Plans $9,682 9065%
Providence Clevercare Mcr Adv $9,682 9065%
Heritage Prov Ntwrk/Regal Mcr Adv $9,827 9200%
Clever Care Mcr Adv - All Plans $10,166 9518%
La Salle Hp Mcr Adv-All Plans $10,166 9518%
Providence Oscar-All Other Plans $10,166 9518%
Alpha Care Mg-All Other Plans $12,102 11330%
Heritage Prov Ntwrk/Regal - All Other Plans $17,791 16657%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals