CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $2,523
  • Cash Discount Price: $2,285
  • vs. Medicare Baseline: 23.62x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at HSHS St Elizabeth's Hospital is $2,523. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,285. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.62x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$2,285

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,523

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: $2,285 (2139%)
Insurance Median: $2,523 (2362%)
Cash: $2,285 (2139% of Medicare)
Ins. Median: $2,523 (2362% 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 2362% of the Medicare baseline (a markup of 2262%). 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
Molina Healthcare $97 - $124 91%
Meridian Health Plan $102 95%
Aetna $119 - $2,234 111%
Blue Cross Blue Shield $119 - $3,173 111%
Clear Spring Health Of Illinois $119 111%
Health Alliance Medical Plans $119 - $2,697 111%
Health Partners $119 111%
Humana $119 111%
Sae Hospice $119 111%
UnitedHealthcare $119 - $3,173 111%
Celtic Insurance Company $237 222%
Naphcare $257 241%
Hopetrust $285 267%
Claim Doc $297 278%
Amish Community $888 831%
Wellfirst $2,043 1913%
Cigna $2,290 - $3,173 2144%
First Health $2,361 2210%
Healthlink $2,523 - $3,173 2362%
Caterpillar, Inc. $2,548 2386%
Consociate Group $2,792 2614%
Choicecare $2,856 2674%
Healthcare Finest Network (Hfn) $2,856 2674%
Multiplan/Phcs $2,856 2674%
Provider Network Of America $2,856 2674%
City Of Springfield $3,173 2971%
Current Health Solutions $3,173 2971%
Healthscope $3,173 2971%
Illinois Breast And Cervical Cancer Program $3,173 2971%
Interplan $3,173 2971%
Live360 $3,173 2971%
Wexford $3,173 2971%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals