CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Bob Wilson Memorial Hospital

Billing Code: 71250 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$483
about 4.5× the $107 Medicare rate · typically $138–$866
modeled estimate · not a bill or quote
What this hospital charges insurers
$489
About the fair price
about $6 over the fair price · 4.6× Medicare
Medicare pays $107 Fair price $483 This hospital $489 Cash price $995 Hospital's list price $2,486

How we calculate the fair BaseRate →

How this hospital compares to other KS hospitals

Highest price of the 9 KS hospitals we have prices for — worth calling around.

Cheapest $69 Priciest $489

Black dot = this hospital, among the 9 KS hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, chest (no contrast) is about $483 (about 4.5× the $107 Medicare rate). Bob Wilson Memorial Hospital charges insurers about $489, or about $995 in cash — about the fair price. Located in Ulysses, KS.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $796 - $2,074 745%
Blue Cross Blue Shieldmajor $641 600%
Aetnamajor $796 - $1,989 745%
Humanamajor $796 745%
HealthPartners $2,337 2188%
+ 3 smaller / regional plans $337 - $2,362
Government programs also on file: Medicare.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 415 N Main Street, Ulysses, KS 67880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals