CT scan, chest (no contrast)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $855
- Cash Discount Price: $760
- vs. Medicare Baseline: 8.00x 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 800% of the Medicare baseline (a markup of 700%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $430 - $453 | 403% |
| UnitedHealthcare | $855 - $950 | 800% |
| Providers Care (Wppa)-All Plans | $1,662 | 1556% |
Consumer Guidance & Cost Commentary
For the CPT code 71250 (CT scan, chest, no contrast), the facility's cash median rate of $760.00 is lower than the negotiated rates paid by UnitedHealthcare ($855.00) and Providers Care ($1,662.00). This suggests that patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance allowed amount, which could result in lower out-of-pocket costs if the patient's deductible has not been met. While the facility is a Critical Access Hospital in Anthony, KS, serving the 67003 zip code, the data does not provide specific county or state average benchmarks for this procedure to compare against.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling. If you are paying out-of-pocket, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if you receive a bill, request a full itemized statement to ensure no errors exist, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Always compare the final amount to the Medicare benchmark of $106.81 to understand the true cost relative to federal rates, rather than relying on the facility's gross charge of $950.00.