CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Pinckneyville Community Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $1,152
Cash Discount Price: $3,052
vs. Medicare Baseline: 10.79x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Pinckneyville Community Hospital is $1,152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,052. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.79x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$3,052

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,152

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: $3,052 (2857%)

Insurance Median: $1,152 (1079%)

Cash: $3,052 (2857% of Medicare)

Ins. Median: $1,152 (1079% 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 1079% of the Medicare baseline (a markup of 979%). 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	$29 - $3,137	27%
Ambetter / Centene	$29 - $582	27%
Blue Cross Blue Shield	$29 - $2,510	27%
Medicaid / KanCare	$29 - $582	27%
Umwa Mcr Adv - All Plans	$49 - $1,290	46%
UnitedHealthcare	$49 - $2,859	46%
Wellcare Mcr Adv - All Plans	$49 - $1,290	46%
Humana	$51 - $1,290	48%
Cigna	$59 - $2,876	55%
Healthlink Hmo	$192 - $2,737	180%
Healthlink Ppo - All Other Plans	$192 - $2,876	180%
Phcs Savility	$264 - $2,963	247%
Multiplan - All Plans	$279 - $3,137	261%
Phcs - All Other Plans	$279 - $2,859	261%
Healthlink Work Comp	$2,518 - $2,876	2357%

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 $3,052.
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 Pinckneyville Community 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.