CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Monroe Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $195
Cash Discount Price: $110
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Monroe Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.83x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $110 (103%)

Insurance Median: $195 (183%)

Cash: $110 (103% of Medicare)

Ins. Median: $195 (183% 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.

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	$110 - $650	103%
Blue Cross Blue Shield	$110 - $381	103%
Care Source	$110 - $381	103%
Medicare (plans)	$110	103%
Tricare	$110	103%
UnitedHealthcare	$110 - $381	103%
Usa Senior Care Network	$110	103%
Worthington Christian Fellowship	$110	103%
Monroe Medical Group And Managed Health Services	$112 - $381	105%
Provider Partners Health Plan	$121	113%
Employer Direct Healthcare	$154	144%
Pathfinder Advisor	$163	153%
Corvel Workers Compensation	$192	180%
Zelis Healthcare Fka Stratose	$209	196%
Americas Choice Provider Network Acpn	$214	200%
Multiplan	$214	200%
Prime Health Services	$214	200%
Three Rivers	$214	200%
Encore Health Network Workers Compensation	$216	202%
Provider Select	$218	204%
Provider Network Of America	$220	206%
Workers Compensation	$220	206%
Medicaid / KanCare	$381	357%

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 $110.
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 Monroe 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.