CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Pulaski Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $123
Cash Discount Price: $1,200
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Pulaski Memorial Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,200. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$1,200

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $1,200 (1123%)

Insurance Median: $123 (115%)

Cash: $1,200 (1123% of Medicare)

Ins. Median: $123 (115% 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
Ambetter / Centene	$48 - $1,017	45%
Blue Cross Blue Shield	$48 - $2,111	45%
Caresource Mcaid Hip	$48 - $1,017	45%
Caresource Mcare Hmo	$48 - $1,017	45%
Cenpatico Mcaid Hip	$48 - $1,017	45%
Humana	$48 - $2,638	45%
Mdwise Mcaid Hcc	$48 - $98	45%
Mdwise Mcaid Hhw	$48 - $98	45%
Mdwise Mcaid Hip - All Other Plans	$48 - $1,017	45%
Mhs Mcaid Hip	$48 - $1,017	45%
Mhs Mcare Allwell	$48 - $1,027	45%
Multiplan - All Plans	$48 - $2,953	45%
UnitedHealthcare	$48 - $2,592	45%
Caresource Exch Hmo Hix - All Other Plans	$59 - $1,271	55%
Encore Ppo - All Other Plans	$72 - $2,789	67%
Cigna	$89 - $3,117	83%
Sagamore - All Other Plans	$89 - $2,480	83%
Sagamore Rose Acre	$89 - $2,444	83%
Community Health Alliance - All Plans	$94 - $2,920	88%
Caresource Mcaid Hhw	$98 - $123	92%
Cenpatico Mcaid Hhw - All Other Plans	$98 - $123	92%
Mhs Mcaid Hhw/Hcc	$98 - $123	92%
Encore Workers Comp	$134 - $2,953	125%
Aetna	$1,181	1106%

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 $1,200.
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 Pulaski 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.