CT scan, chest (no contrast)
Facility: Phillips County Hospital
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $580
- Cash Discount Price: $515
- vs. Medicare Baseline: 5.43x 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 543% of the Medicare baseline (a markup of 443%). 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 | $464 - $632 | 434% |
| Blue Cross Blue Shield | $470 - $512 | 440% |
| Medicaid / KanCare | $580 - $632 | 543% |
| Health Partners-All Plans | $580 - $632 | 543% |
Consumer Guidance & Cost Commentary
For a CT scan of the chest without contrast at Phillips County Hospital in Phillipsburg, KS, the facility's cash price of $515.00 is lower than the average negotiated rates paid by major insurers, which range from $464 to $632 depending on the plan. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price directly more affordable than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the facility offers a cash rate, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost by bypassing the administrative overhead associated with insurance billing cycles.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup; the cash price of $515.00 represents a significant increase over this federal rate, reflecting the local cost of care and facility expenses. Although the facility is in-network for UnitedHealthcare, Blue Cross Blue Shield, Medicaid/KanCare, and Health Partners, the specific allowed amounts vary by plan, with some paying as low as $464 and others up to $632. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but if unexpected charges arise, they should request an itemized billing audit to identify any errors, unbundled codes, or services not rendered before agreeing to pay the full amount.