CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Alton Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $877
Cash Discount Price: $709
vs. Medicare Baseline: 8.21x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Alton Memorial Hospital is $877. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $709. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.21x the Medicare baseline. Located in One Memorial Drive, Alton, IL.

Cash / Self-Pay

$709

Average discount available for prompt cash payment at this facility.

Insurance Median

$877

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: $709 (664%)

Insurance Median: $877 (821%)

Cash: $709 (664% of Medicare)

Ins. Median: $877 (821% 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 821% of the Medicare baseline (a markup of 721%). 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
Aetna	$112 - $886	105%
Blue Cross Blue Shield	$112 - $1,027	105%
Humana	$112 - $1,402	105%
UnitedHealthcare	$112 - $1,009	105%
Essence Healthcare [221]	$115	108%
Cox Health [757]	$118	110%
Devoted Health Plan [847]	$118	110%
Medica [662]	$118	110%
Healthlink [225]	$573 - $892	536%
Cigna	$597 - $945	559%
Allied Benefits [498]	$630 - $877	590%
Coresource [497]	$630	590%
Fmh Benefit Service Inc [222]	$630	590%
Mail Handlers [495]	$630	590%
Cox Health Systems Insurance Company [220]	$650 - $768	609%
Hope Trust [806]	$685	641%
Consociate [478]	$694	650%
Sarah Bush Lincoln [636]	$694	650%
Med-Pay [480]	$768 - $886	719%
Unicare [568]	$768 - $892	719%
First Health Commercial [734]	$877	821%
Beechstreet [551]	$886	830%
Detego Health [868]	$886	830%
Health Systems Inc [620]	$886	830%
Healthcare Sol Mercy [609]	$886	830%
Multiplan Commercial [737]	$886	830%
Multiplan [240]	$886	830%
Phcs [244]	$886 - $945	830%
Preferred Health Professionals [561]	$892	835%
Apwu Health Plan [216]	$916	858%
Nalc Health Benefit Plan [242]	$916	858%
Priority Health [648]	$916	858%
Hfn [563]	$945	885%
Medica [661]	$945	885%
Healthscope Benefits [258]	$1,009	945%
Health Alliance [224]	$1,500	1404%

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 $709.
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 Alton Memorial 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.