CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $391
  • Cash Discount Price: $1,772
  • vs. Medicare Baseline: 3.66x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Mercy Specialty Hospital Southeast Kansas is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,772. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.66x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$1,772

Average discount available for prompt cash payment at this facility.

Insurance Median
$391

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: $1,772 (1659%)
Insurance Median: $391 (366%)
Cash: $1,772 (1659% of Medicare)
Ins. Median: $391 (366% 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 366% of the Medicare baseline (a markup of 266%). 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
Medicaid / KanCare $60 - $215 56%
Blue Cross Blue Shield $60 - $490 56%
Humana $71 - $104 66%
Aetna $71 - $104 66%
Provider Partners Health Plans Contracted [320450] $76 71%
UnitedHealthcare $91 - $2,522 85%
Qual Choice Contracted [320325] $102 95%
Pace Of The Ozarks Contracted [320518] $102 95%
Mercy Mgd Behavioral Health Contracted [320259] $102 95%
Kindful Hospice [20434] $102 95%
Cigna $102 - $467 95%
Cross Timbers Hospice [20098] $102 95%
Medical Associates Health Contracted [320444] $102 95%
Elara Caring Aspire Hospice [20433] $102 95%
Halo Hcr Inc Hospice [20432] $102 95%
Kindful Hospice Contracted [320434] $102 95%
Cherokee Nation Health Serv Contracted [320066] $102 95%
Tricare $102 95%
Globalhealth Contracted [320145] $102 95%
Medicare (plans) $102 95%
Mercy Hospice Okc [20252] $102 95%
Halo Hcr Inc Hospice Contracted [320432] $102 95%
Dept Of Veteran Affairs Contracted [320106] $104 97%
First Health Contracted [320128] $104 97%
Centivo Contracted [320505] $104 97%
United Medical Resources Contracted [320454] $114 - $391 107%
Providrs Care Network Contracted [320484] $197 184%
Healthscope Contracted [320182] $391 - $2,044 366%
Insurance System Inc Contracted [320465] $391 366%
Point C Contracted [320238] $391 - $2,044 366%
Health Systems Inc Contracted [320174] $391 366%
Benefit Management Contracted [320052] $391 366%
Medica Contracted [320239] $734 687%
Mercy Benefit Admin Contracted [320251] $836 - $1,908 783%
Show-Me Health Administrators Contracted [320483] $836 783%
Reflect Health Contracted [320492] $1,908 1786%
Auxiant Contracted [320462] $1,908 - $2,044 1786%
Ebms Contracted [320493] $1,908 1786%
Imagine 360 Contracted [320494] $1,908 1786%
American Healthcare Alliance Contracted [320020] $1,908 1786%
Aither Health Contracted [320449] $1,908 1786%
Edison Health Solutions Contracted [320502] $1,908 1786%
Yuzu Health Contracted [320521] $1,908 1786%
Federal Medical Center Contracted [320127] $2,044 1914%
Healthlink Contracted [320179] $2,044 1914%
Preferred Health Plan Contracted [320522] $2,044 1914%
Compcare Of The Ozarks Contracted [320437] $2,154 2017%
Workers Comp [20426] $2,181 2042%
Private Health Care Systems Contracted [320320] $2,522 2361%
Multiplan [20270] $2,590 2425%
Multiplan Contracted [320270] $2,590 2425%

Consumer Guidance & Cost Commentary

For the CPT code 71250 (CT scan, chest, no contrast), the facility's cash median price of $1,772 is significantly lower than the negotiated rates charged to most insurance plans, which range from $60 to $2,590. While the facility's gross charge is $2,726, patients with high-deductible plans may find the cash price more affordable than their insurance allowed amounts, which can exceed $2,000 for certain payers like UnitedHealthcare and Point C. It is important to note that commercial negotiated rates often include administrative overhead and contract structures that can inflate the baseline price by 20% to 40% compared to the actual cost of care.

To minimize out-of-pocket costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50%. Additionally, if you receive a bill from an out-of-network provider at this facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services. If you do receive a balance bill, you should request a formal itemized audit to identify errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through written dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals