CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Adventist Health Lodi Memorial

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $175
  • Cash Discount Price: $169
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Adventist Health Lodi Memorial is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.64x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$169

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $169 (158%)
Insurance Median: $175 (164%)
Cash: $169 (158% of Medicare)
Ins. Median: $175 (164% 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.

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
Cigna $27 - $7,881 25%
Alignment Health Plan (Ahp)-All Plans $50 - $138 47%
Blue Shield Mcare Adv $50 - $138 47%
Healthnet Mcare $50 - $138 47%
Hp Of San Joaquin Mcr Adv $50 - $138 47%
Humana $50 - $138 47%
Knnex Health - All Plans $50 - $165 47%
Tricare $50 - $138 47%
UnitedHealthcare $50 - $3,635 47%
Hp Healthy Kids Pro Fee $53 50%
Ah Employee Health Plan - All Plans $55 - $248 51%
First Health- All Plans $60 - $5,500 56%
Beech Street- All Plans $65 - $7,881 61%
Hp Of San Joaquin Ppo - All Other Plans $65 - $8,319 61%
Multiplan- All Plans $65 - $7,006 61%
Kaiser Commercial - All Other Plans $68 - $3,590 64%
Kaiser Mcr Adv $68 - $138 64%
Networks By Design- All Plans $68 - $3,500 64%
Healthnet- All Other Plans $73 - $4,301 68%
Western Growers- All Plans $77 - $7,881 72%
Blue Shield Epn - All Other Plans $88 - $2,837 82%
Blue Shield Non-Epn $93 - $2,942 87%
Blue Cross Blue Shield $102 - $1,844 95%
Bc Mcal $127 - $138 119%
Celtic Ins Company - All Plans $127 - $261 119%
Kaiser Mcal $127 - $233 119%
Medi-Cal $127 - $233 119%
Cca Health Plan Mcr Adv- All Plans $138 129%
Hp Mcal Pro Fee $140 131%
Healthnet Mcal $153 - $333 143%
Hp Of San Joaquin Mcal $153 - $292 143%
Bright Health - All Plans $276 258%
Aetna $281 - $2,315 263%
Medcore(Omni Ipa) Op Only- All Plans $629 - $2,277 589%
Three Rivers Provider Network- All Plans $2,178 - $7,881 2039%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals