CT scan, chest (no contrast)
Facility: Graham County Hospital
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $488
- Cash Discount Price: $630
- vs. Medicare Baseline: 4.57x 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 457% of the Medicare baseline (a markup of 357%). 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 |
|---|---|---|
| Medicaid / KanCare | $171 | 160% |
| UnitedHealthcare | $171 - $598 | 160% |
| Blue Cross Blue Shield | $453 | 424% |
| Medicare (plans) | $472 | 442% |
| Celtic Commercial-All Other Plans | $520 | 487% |
| Wppa (Providers Care)-All Plans | $598 | 560% |
Consumer Guidance & Cost Commentary
For the CPT code 71250, representing a chest CT scan without contrast, Graham County Hospital in Hill City, KS, lists a cash median price of $630.00. This cash rate is notably higher than the state average for this procedure, which is $488.00. While commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $453 to $598, patients with high-deductible plans should consider that paying the cash price directly might be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can significantly reduce the final cost.
The facility's Medicare allowed amount for this service is $106.81, which serves as a critical benchmark for evaluating pricing fairness. Commercial negotiated rates for this procedure average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare. Given that the cash price of $630.00 is approximately 5.9 times the Medicare rate, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs compared to cash payment. To avoid unexpected balance billing or errors, consumers should request a full itemized bill before paying and verify that all services rendered are accurately coded, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.