CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Jacksonville Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $2,084
Cash Discount Price: $3,754
vs. Medicare Baseline: 19.51x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Jacksonville Memorial Hospital is $2,084. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,754. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.51x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$3,754

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,084

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: $3,754 (3515%)

Insurance Median: $2,084 (1951%)

Cash: $3,754 (3515% of Medicare)

Ins. Median: $2,084 (1951% 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 1951% of the Medicare baseline (a markup of 1851%). 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
Commercial Workers Compensation	$11 - $1,244	10%
Blue Cross Blue Shield	$117 - $4,443	110%
Tricare	$123 - $810	115%
Coventry	$124 - $700	116%
Health Alliance	$124 - $3,021	116%
Humana	$124 - $3,790	116%
Medicare (plans)	$124 - $700	116%
UnitedHealthcare	$130 - $3,199	122%
Medicaid / KanCare	$209	196%
Molina Healthcare	$209	196%
Corvel/Corcare	$1,000 - $1,103	936%
Healthlink	$1,050 - $3,777	983%
Illinois Workers Compensation	$1,074 - $1,309	1006%
Health Alliance Mh Employee Plan	$1,409 - $2,044	1319%
Current Health Network	$1,685 - $3,332	1578%
6 Degrees Health	$1,838 - $2,666	1721%
Hope Trust	$1,838 - $2,666	1721%
Hst	$1,838 - $2,666	1721%
Cigna	$2,123 - $3,079	1988%
Aetna	$2,142 - $3,554	2005%
Phcs/Multiplan	$2,758 - $3,999	2582%
Hfn	$2,911 - $4,221	2725%
Liability	$3,064 - $4,443	2869%

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 $3,754.
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 Jacksonville 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.