CT scan, chest (no contrast)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 71250 (CPT)
- CPT Billing Code: 71250
- Insurance Median: $657
- Cash Discount Price: $659
- vs. Medicare Baseline: 6.15x 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 615% of the Medicare baseline (a markup of 515%). 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 |
|---|---|---|
| Humana | $380 | 356% |
| Tricare | $410 | 384% |
| Va Ccn - All Plans | $480 | 449% |
| Medicaid / KanCare | $480 - $775 | 449% |
| UnitedHealthcare | $480 - $775 | 449% |
| Aetna | $480 - $698 | 449% |
| Ambetter / Centene | $529 | 495% |
| Blue Cross Blue Shield | $657 | 615% |
| Health Partners - All Plans | $736 | 689% |
| Healthy Blue Mcaid - All Plans | $775 | 726% |
Consumer Guidance & Cost Commentary
For the CPT code 71250, representing a chest CT scan without contrast, the facility's cash median price is $659.00, which is lower than the negotiated rates paid by most major payers listed, such as UnitedHealthcare ($480–$775) and Aetna ($480–$698). This pricing structure suggests that patients with high-deductible plans or those without insurance may save money by paying the cash price directly, as the facility's cash rate is significantly lower than the commercial negotiated ceilings. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by an additional 20% to 50% by bypassing administrative claim processing costs.
The facility's negotiated rate of $657.00 is slightly below the gross charge of $775.00 but remains substantially higher than the Medicare benchmark of $106.81, indicating a markup typical of commercial contracts. While the facility is a Critical Access Hospital in Wakeeney, KS, the data provided does not include specific county or state average comparisons for this procedure, so the $659.00 cash median serves as the primary reference for out-of-pocket costs. Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, and if a surprise bill arises, they should request an itemized audit to identify unbundled codes or services not rendered before making any payment.