CT scan, chest (no contrast)
Facility: Hiawatha Community Hospital
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $901
- Cash Discount Price: $1,156
- vs. Medicare Baseline: 8.44x 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 844% of the Medicare baseline (a markup of 744%). 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 |
|---|---|---|
| UnitedHealthcare | $428 - $993 | 401% |
| Aetna | $428 - $934 | 401% |
| Humana | $432 | 404% |
| Blue Cross Blue Shield | $456 - $480 | 427% |
| Ambetter / Centene | $513 | 480% |
| Oscar - All Plans | $867 | 812% |
| Centrus Health Direct - All Plans | $867 | 812% |
| Preferred Hlth - All Plans | $1,040 | 974% |
| Wppa Providrs Care - All Plans | $1,098 | 1028% |
| Cigna | $1,098 | 1028% |
| Midlands Choice - All Plans | $1,121 | 1050% |
| Multiplan - All Plans | $1,121 | 1050% |
| Healthy Blue Mcaid - All Plans | $1,156 | 1082% |
Consumer Guidance & Cost Commentary
For the CPT code 71250 (CT scan, chest, no contrast) at Hiawatha Community Hospital, the cash price is $1,156.00, which matches the facility's gross charge and the cash median. While commercial insurance negotiated rates range from $428 to $1,156 depending on the plan, the cash price is notably higher than the median negotiated rate of $901.00 and the lowest negotiated rate of $428. This suggests that for patients with high-deductible plans or those without insurance, paying the cash price directly may be more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. Patients should verify their specific plan's deductible status and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill.
The facility's pricing is also evaluated against Medicare benchmarks, where the Medicare amount for this service is $106.81. The cash price of $1,156.00 represents a significant markup compared to this federal baseline, highlighting the difference between government-set cost baselines and commercial pricing structures. Although the data does not provide specific state or county average comparisons for this exact code, the wide variance in negotiated rates across 13 different payers—from $428 to $1,156—underscores the importance of checking individual plan details. To avoid unexpected costs, consumers should request an itemized bill to review specific CPT codes and ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that