CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Witham Health Services

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $1,651
Cash Discount Price: $1,678
vs. Medicare Baseline: 15.46x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Witham Health Services is $1,651. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,678. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.46x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$1,678

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,651

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: $1,678 (1571%)

Insurance Median: $1,651 (1546%)

Cash: $1,678 (1571% of Medicare)

Ins. Median: $1,651 (1546% 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 1546% of the Medicare baseline (a markup of 1446%). 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
Blue Cross Blue Shield	$98 - $1,888	92%
Mdwise Health In-All Plans	$111	104%
Caresource Mcr Adv	$113	106%
Aetna	$114 - $1,774	107%
Caresource Indiana Marketplace-All Other Plans	$210	197%
UnitedHealthcare	$1,870	1751%
Phcs/Multiplan-All Plans	$2,181	2042%
Sagamore-All Plans	$2,205	2064%
Humana	$2,229	2087%
Beech Street-All Plans	$2,253	2109%
Encore-All Plans	$2,277	2132%
Mhs Comml Exch-All Plans	$5,993	5611%

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 $1,678.
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 Witham Health Services 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.