CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Nmc Health

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $949
  • Cash Discount Price: $1,107
  • vs. Medicare Baseline: 8.88x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Nmc Health is $949. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,107. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.88x the Medicare baseline. Located in 600 Medical Center Drive, Newton, KS.
Cash / Self-Pay
$1,107

Average discount available for prompt cash payment at this facility.

Insurance Median
$949

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: $1,107 (1036%)
Insurance Median: $949 (888%)
Cash: $1,107 (1036% of Medicare)
Ins. Median: $949 (888% 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 888% of the Medicare baseline (a markup of 788%). 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
Bluestem Pace $101 95%
Medicaid / KanCare $162 152%
Leading Age $162 152%
Aetna $409 - $1,303 383%
Blue Cross Blue Shield $480 449%
Wppa $870 815%
Occunet $949 888%
Medincrease Health Plan $1,028 962%
Samaritan Ministries International $1,028 962%
Prime Health Services $1,186 1110%
UnitedHealthcare $1,423 1332%
Cigna $1,502 1406%

Consumer Guidance & Cost Commentary

For a chest CT scan without contrast at Nmc Health in Newton, Kansas, the facility's cash price of $1,107 is notably lower than the average negotiated rates charged by major insurers, which range from $409 to $1,502 depending on the plan. While the facility offers a cash rate of $1,107, many commercial payers negotiate rates that exceed this amount, meaning patients with high-deductible plans might save money by paying the cash price directly rather than relying on insurance. It is important to note that the facility's cash rate is also significantly higher than the Medicare benchmark of $106.81, which serves as the objective baseline for fair pricing; commercial rates often reflect administrative overhead and contract structures that can inflate costs well above the true cost of care.

Patients should be aware that while the No Surprises Act protects against balance billing for emergency services at in-network facilities, unexpected charges can still occur if ancillary services like lab tests are provided by out-of-network providers. To avoid surprise bills, consumers should request an itemized billing audit before paying, ensuring no unbundled codes or services not rendered are included in the final invoice. Additionally, since hospitals often offer prompt-pay discounts for upfront payment, patients should explicitly ask about self-pay or prompt-pay rates at the time of scheduling to potentially reduce their out-of-pocket costs further before any insurance claim is processed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Medical Center Drive, Newton, KS 67114
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals