CT scan, chest (no contrast)
Facility: Decatur Health
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $852
- Cash Discount Price: $1,005
- vs. Medicare Baseline: 7.98x 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 798% of the Medicare baseline (a markup of 698%). 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 | $589 | 551% |
| Wppa/Providrs Care- All Plans | $670 | 627% |
| UnitedHealthcare | $681 - $852 | 638% |
| Humana | $688 | 644% |
| Aetna | $1,005 - $1,116 | 941% |
| Midlands Choice- All Plans | $1,005 | 941% |
| Medicaid / KanCare | $1,128 | 1056% |
Consumer Guidance & Cost Commentary
For the CPT code 71250 (CT scan, chest, no contrast) at Decatur Health in Oberlin, KS, the facility's cash median price is $1,005, which is notably lower than the gross charge of $1,116. While the facility is in-network for seven payers, their negotiated rates range from $589 to $1,128, with UnitedHealthcare showing a spread between $681 and $852 depending on the specific plan. It is important to note that for patients with high-deductible plans, paying the cash price of $1,005 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates for some carriers exceed the cash amount. Additionally, patients should explicitly ask the hospital about "prompt-pay" discounts before scheduling, as paying the bill in full within 30 days can often reduce the total cost by 20% to 50% by bypassing administrative claim processing fees.
This service is provided by a Critical Access Hospital, a facility type often subject to specific federal pricing regulations that may influence their rates. The data indicates a comparison metric of 8.0 against Medicare, suggesting the facility's pricing structure is evaluated relative to the federal government's fixed reimbursement baseline of $106.81 for this procedure. While the report does not provide specific county or state average figures for this exact code to make a direct comparison, the facility's ownership as a voluntary non-profit private entity and its location in zip code 67749 are key identifiers for transparency. Consumers are advised to request a full itemized bill before paying, as summary invoices