CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Doctors Memorial Hospital Inc

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $189
Cash Discount Price: $237
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Doctors Memorial Hospital Inc is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.77x the Medicare baseline. Located in 333 N Byron Butler Pkwy, Perry, FL.

Cash / Self-Pay

$237

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $237 (222%)

Insurance Median: $189 (177%)

Cash: $237 (222% of Medicare)

Ins. Median: $189 (177% 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.

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
Humana	$105 - $189	98%
Aetna	$189 - $756	177%
Blue Cross Blue Shield	$189 - $536	177%
Medicare (plans)	$189	177%
Sunshine	$189	177%
Uhc_Va_Ccn	$189	177%
Cigna	$355	332%
UnitedHealthcare	$414	388%
Multiplan	$503	471%

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 $237.
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 Doctors Memorial Hospital Inc 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.