CT scan, chest (no contrast)
Facility: Ellsworth County Medical Center
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $522
- Cash Discount Price: $693
- vs. Medicare Baseline: 4.89x 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 489% of the Medicare baseline (a markup of 389%). 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 |
|---|---|---|
| Triwest -All Plans | $251 - $400 | 235% |
| Healthy Blue Mcr Adv | $251 - $400 | 235% |
| Va Ccn-All Plans | $251 - $400 | 235% |
| Humana | $251 - $808 | 235% |
| UnitedHealthcare | $348 - $850 | 326% |
| Blue Cross Blue Shield | $430 - $453 | 403% |
| Aetna | $482 - $765 | 451% |
| First Health - All Plans | $482 - $765 | 451% |
| Cigna | $508 - $808 | 476% |
| Coventry Mcaid-All Plans | $535 - $850 | 501% |
| Medicaid / KanCare | $535 - $850 | 501% |
| Healthy Blue Mcaid- All Other Plans | $535 - $850 | 501% |
| Providers Care-Wppa-All Plans | $802 - $1,275 | 751% |
Consumer Guidance & Cost Commentary
For the CPT code 71250, representing a CT scan of the chest without contrast, the cash price at Ellsworth County Medical Center is $693. This cash rate aligns exactly with the facility's reported median paid amount. While the facility is a Critical Access Hospital in Ellsworth, Kansas, with a facility rating of 2, the cash price is notably higher than the Medicare benchmark of $106.81. Under Medicare benchmarking principles, commercial rates often range from 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150%. In this instance, the cash price represents a significant markup over the federal baseline, which serves as the objective cost standard for evaluating hospital pricing.
Insurance negotiated rates for this procedure vary widely across payers, ranging from a low of $251 to a high of $1,275, with a median negotiated rate of $522. Although the median negotiated rate of $522 is lower than the cash price of $693, patients should be aware that commercial rates include administrative overhead and contractual ceilings that can sometimes exceed cash prices. Additionally, the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, though emergency physicians or ancillary lab services may still trigger unexpected charges if not properly managed. To minimize costs, patients are encouraged to verify their specific plan's deductible status and ask the facility directly about "self-pay" or "prompt-pay" discounts, which can offer further reductions for upfront payment.