CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Perry County Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $1,302
Cash Discount Price: $1,551
vs. Medicare Baseline: 12.19x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Perry County Memorial Hospital is $1,302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,551. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.19x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.

Cash / Self-Pay

$1,551

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,302

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: $1,551 (1452%)

Insurance Median: $1,302 (1219%)

Cash: $1,551 (1452% of Medicare)

Ins. Median: $1,302 (1219% 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 1219% of the Medicare baseline (a markup of 1119%). 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
Medicaid / KanCare	$381 - $2,216	357%
Veterans Administration	$554 - $2,216	519%
Bc 130	$576 - $1,771	539%
Group Insurance	$576 - $2,216	539%
Medicare (plans)	$576	539%
Workers Compensation	$1,108	1037%
Nsa	$1,302 - $1,368	1219%
Guarantor Liable	$1,551 - $2,216	1452%
Pcmh Insurnace	$1,728 - $2,216	1618%
Secondary Insurance	$1,771	1658%
UnitedHealthcare	$1,771	1658%
Operating Engineers	$1,884	1764%
Boilermakers Healthcare	$1,928	1805%
Cigna	$1,928	1805%
Great West	$1,928 - $2,216	1805%
Sagxxxx	$1,928	1805%
Champus	$2,216	2075%
Ngs American, Inc	$2,216	2075%
Patoka Valley	$2,216	2075%
Southwire	$2,216	2075%
Tricare	$2,216	2075%
Wausau Benefits	$2,216	2075%

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 $1,551.
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 Perry County 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.