CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Mercy Medical Center-New Hampton

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $2,096
Cash Discount Price: $1,442
vs. Medicare Baseline: 19.62x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Mercy Medical Center-New Hampton is $2,096. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,442. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.62x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.

Cash / Self-Pay

$1,442

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,096

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: $1,442 (1350%)

Insurance Median: $2,096 (1962%)

Cash: $1,442 (1350% of Medicare)

Ins. Median: $2,096 (1962% 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 1962% of the Medicare baseline (a markup of 1862%). 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
Blue Cross Blue Shield	$878	822%
Aetna	$887 - $2,096	830%
Medicare (plans)	$896 - $991	839%
UnitedHealthcare	$940 - $1,331	880%
Health Choices	$1,120	1049%
Medical Associates	$1,120	1049%
Amish Hospital Aid	$1,180	1105%
Oscar	$1,304	1221%
Geha	$1,331	1246%
Ambetter / Centene	$1,490	1395%
Iowa Total Care	$1,516	1419%
Medicaid / KanCare	$1,538 - $1,546	1440%
Claimdoc	$1,783	1669%
Nova	$1,783	1669%
1199 National Benefit Fund	$2,096	1962%
Allied Benefit Systems	$2,096	1962%
Asr Health Benefits	$2,096	1962%
Coventry	$2,096	1962%
First Health	$2,096	1962%
Lucent Health	$2,096	1962%
Luminare Health	$2,096	1962%
Medical Mutual	$2,096	1962%
Meritain	$2,096	1962%
Trustmark Small Business Benefits	$2,096	1962%
Webtpa	$2,096	1962%
First Choice Health	$2,107	1973%
Health Partners	$2,132	1996%
Auxiant	$2,151	2014%
Cigna	$2,151	2014%
Medica	$2,151	2014%
Midlands	$2,151	2014%
Midlands Choice	$2,151	2014%
Crime Victim Assistance	$2,218	2077%
Iowa Dept Of Public Health	$2,218	2077%

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 $1,442.
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 Mercy Medical Center-New Hampton 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.