CT scan, chest (no contrast)
Facility: Rooks County Health Center
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $710
- Cash Discount Price: $592
- vs. Medicare Baseline: 6.65x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 665% of the Medicare baseline (a markup of 565%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $371 | 347% |
| Veterans Admin - All Plans | $371 | 347% |
| Celtic Mcr Adv | $371 | 347% |
| Celtic Comm - All Other Plans | $408 | 382% |
| Blue Cross Blue Shield | $480 | 449% |
| UnitedHealthcare | $710 | 665% |
| Preferred Benefits Admin | $710 | 665% |
| Aetna | $710 | 665% |
| Preferred Hlthcare - All Other Plans | $749 | 701% |
| Health Partners - All Plans | $749 | 701% |
| Healthy Blue Mcaid - All Plans | $789 | 739% |
Consumer Guidance & Cost Commentary
For the CT scan of the chest without contrast at Rooks County Health Center in Plainville, Kansas, the facility's cash price of $592 is lower than the median negotiated rate of $710 paid by most major insurers, including UnitedHealthcare, Aetna, and Blue Cross Blue Shield. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to administrative fees and negotiated rate structures. The facility offers a prompt-pay discount for upfront payments, which can further reduce the final bill, and patients should explicitly request self-pay pricing before scheduling to avoid being processed through the insurance billing cycle.
The Medicare benchmark for this procedure is $106.81, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific county or state average comparisons for this code, the significant difference between the Medicare rate and the cash price highlights the substantial markup inherent in commercial billing. To ensure you are not overcharged, it is advisable to request an itemized billing audit if you receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you encounter a balance bill from an out-of-network provider, you may be protected under the No Surprises Act, which prohibits surprise billing for emergency care and non-emergency services at in-network facilities.