CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Johnson Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $612
  • Cash Discount Price: $676
  • vs. Medicare Baseline: 5.73x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Johnson Memorial Hospital is $612. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $676. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.73x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$676

Average discount available for prompt cash payment at this facility.

Insurance Median
$612

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: $676 (633%)
Insurance Median: $612 (573%)
Cash: $676 (633% of Medicare)
Ins. Median: $612 (573% 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 573% of the Medicare baseline (a markup of 473%). 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
Connecticut Dept Of Correction $116 109%
Aetna $123 - $281 115%
Blue Cross Blue Shield $123 - $612 115%
Medicare (plans) $123 - $129 115%
UnitedHealthcare $123 - $1,229 115%
Cca Senior Care Options $125 117%
Cigna $127 - $959 119%
Fallon Health $163 153%
Geha $179 168%
Harvard Pilgrim Healthcare $179 168%
Claimdoc $263 246%
Diversified Administrators $263 246%
Innovative Health Plan Ii $263 246%
1199 National Benefit Fund $281 263%
Allied Benefit Systems $281 263%
Gravie Admin Services $281 263%
Hap $281 263%
Luminare Health $281 263%
Meritain $281 263%
Nippon Life Ins $281 263%
Webtpa $281 263%
Centivo $292 273%
Allegiance $391 366%
Health Partners $391 366%
Magnacare $391 366%
Bcn Domestic $612 573%
Blue Benefit Administrators Of Massachusetts $612 573%
Blue Care Network $612 573%
Blue Distinction Transplant $612 573%
Blue Shield - Ca $612 573%
Blue Shield - Id (Regence) $612 573%
Blue Shield - Ny Highmark Northeastern $612 573%
Blue Shield - Ny Highmark Western $612 573%
Blue Shield - Pa (Highmark) $612 573%
Blue Shield - Wa (Regence) $612 573%
Health Choices $612 573%
Kaiser Domestic $612 573%
Pre-Employment $612 573%
Unicare $612 573%
Wc Domestic $612 573%
Wellpoint $612 573%
Connecticare $614 - $768 575%
Health New England $799 748%
Prime Health Services $983 920%
Allied National Global Care $1,020 955%
Asrm - Reliance Standard Life Insurance $1,020 955%
Christian Care Ministry $1,020 955%
Dean Health $1,020 955%
Family Life Insurance Company $1,020 955%
Ghc Scw $1,020 955%
International Benefit Administrators $1,020 955%
Lifetime Benefit Solutions $1,020 955%
Manhattan Life $1,020 955%
Medi Share $1,020 955%
Multiplan $1,020 955%
Mvp $1,020 955%
Pai $1,020 955%
Pan-American Life $1,020 955%
Paramount Hmo $1,020 955%
Phcs $1,020 955%
Trinity Health Share $1,020 955%
Health Smart $1,045 978%
United Behavioral Health Eap $1,229 1151%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals