CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Goshen Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $217
  • Cash Discount Price: $1,238
  • vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Goshen Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,238. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.03x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$1,238

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $1,238 (1159%)
Insurance Median: $217 (203%)
Cash: $1,238 (1159% of Medicare)
Ins. Median: $217 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Advantage Health Solutions $217 203%
Aetna $217 203%
Atrio Health Plans $217 203%
Bc Federal Employee $217 203%
Bc Mcr Advantage Ppo $217 203%
Blue Cross Blue Shield $217 - $348 203%
Buckeye Health Plan $217 203%
Cigna $217 203%
Coventry Health And Life $217 203%
Emblem Health $217 203%
Freedom Healthcare $217 203%
Geisinger Health Plan $217 203%
Health First $217 203%
Healthspring $217 203%
Humana $217 203%
Iehp Empire Health Plan $217 203%
Independent Care Health Plan $217 203%
Kaiser Permanente $217 203%
Mcr Advantra Freedom $217 203%
Mcr Allwell Mhs $217 203%
Mcr Banner Health $217 203%
Mcr Complete $217 203%
Mcr Complete Ppo $217 203%
Mcr Complete Wellmed $217 203%
Mcr Health Alliance $217 203%
Mcr Health Partners Plans $217 203%
Mcr Medical Mutual Of Ohio $217 203%
Mcr Passport Advantage $217 203%
Mcr Secure Horizons Ppo $217 203%
Mcr Texan Plus $217 203%
Mcr Upmc For Life $217 203%
Medicare (plans) $217 - $230 203%
Meridian Complete $217 203%
Optimum Healthcare $217 203%
Paramount Elite $217 203%
Primetime Health Plan $217 203%
Simply Complete Hmo $217 203%
The Umwa H&R Funds $217 203%
Todays Options Pyramid Life $217 203%
Trillium Advantage $217 203%
Ucare For Seniors $217 203%
Ucare Minnesota $217 203%
UnitedHealthcare $217 - $1,001 203%
Wellcare $217 203%
Champva $223 209%
Tricare $223 209%
Mcr Devoted Health Plan $230 215%
Mcr Provider Partners Hlth Pln $245 229%
Ambetter / Centene $312 292%
Mkt Caresource $312 292%
Bc Allied $348 326%
All Savers $1,001 937%
Golden Rule Insurance 2Nd $1,001 937%
Oxford Health $1,001 937%
Uhclic $1,001 937%
Uhss $1,001 937%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals