CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Adventist Health Mendocino Coast

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $233
Cash Discount Price: $1,073
vs. Medicare Baseline: 2.18x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Adventist Health Mendocino Coast is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,073. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.18x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$1,073

Average discount available for prompt cash payment at this facility.

Insurance Median

$233

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: $1,073 (1005%)

Insurance Median: $233 (218%)

Cash: $1,073 (1005% of Medicare)

Ins. Median: $233 (218% 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 218% of the Medicare baseline (a markup of 118%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$50 - $2,381	47%
Tricare	$50 - $1,495	47%
UnitedHealthcare	$50 - $2,470	47%
Blue Cross Blue Shield	$52 - $1,526	49%
Ah Employee Health Plan - All Plans	$55 - $1,587	51%
Healthnet - All Plans	$73 - $1,987	68%
Blue Shield Epn	$88 - $1,154	82%
Blue Shield - All Other Plans	$93 - $2,344	87%
Medi-Cal	$127 - $233	119%
Partnership Hp Mcal-All Plans	$185 - $700	173%
Ahcc - All Plans	$200 - $2,747	187%
Beech Street - All Plans	$200 - $2,747	187%
Great West Hmo/Pos/Epo/Oa	$200 - $1,984	187%
Great West Ppo - All Other Plans	$200 - $2,136	187%
Multiplan - All Plans	$200 - $2,136	187%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,073.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71250.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Mendocino Coast is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71250.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.