CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Virginia Gay Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $791
Cash Discount Price: $1,310
vs. Medicare Baseline: 7.41x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Virginia Gay Hospital is $791. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,310. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.41x the Medicare baseline. Located in 502 North 9Th Avenue, Vinton, IA.

Cash / Self-Pay

$1,310

Average discount available for prompt cash payment at this facility.

Insurance Median

$791

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: $1,310 (1226%)

Insurance Median: $791 (741%)

Cash: $1,310 (1226% of Medicare)

Ins. Median: $791 (741% 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 741% of the Medicare baseline (a markup of 641%). 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
Medicaid / KanCare	$107 - $712	100%
Aetna	$149	140%
Wellmark Hmo	$480	449%
Wellmark Ppo-All Other Plans	$529	495%
UnitedHealthcare	$549 - $791	514%
Va Ccn-All Plans	$597 - $615	559%
Health Alliance Mcr Adv	$629 - $648	589%
Medical Associates-All Plans	$1,210 - $1,246	1133%
Cedar Valley Community Healthcare-All Plans	$1,271 - $1,309	1190%
Humana	$1,291 - $1,330	1209%
Health Partners-All Plans	$1,372 - $1,413	1285%
Healthsmart-All Plans	$1,372 - $1,413	1285%
Corvel-All Plans	$1,501 - $1,546	1405%
Health Alliance-All Other Plans	$1,533 - $1,579	1435%

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 $1,310.
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 Virginia Gay Hospital 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.