CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Good Samaritan Medical Center

Billing Code: 71250 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$174

about 1.6× the $107 Medicare rate · typically $127–$341

modeled estimate · not a bill or quote

What this hospital charges insurers

$175

About the fair price

about $1 over the fair price · 1.6× Medicare

Medicare pays $107 Fair price $174 This hospital $175 Cash price $193 Hospital's list price $429

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

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

Cheapest $113 Priciest $175

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

A fair price for a CT scan, chest (no contrast) is about $174 (about 1.6× the $107 Medicare rate). Good Samaritan Medical Center charges insurers about $175, or about $193 in cash — about the fair price. Located in Brockton, MA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$125	117%
Blue Cross Blue Shieldmajor	$125 - $280	117%
Aetnamajor	$125 - $291	117%
Cignamajor	$257 - $373	241%
Humanamajor	$125	117%
Harvard Pilgrim	$219	205%
Tufts Health Plan	$318 - $373	298%
UniCare	$277	259%
+ 13 smaller / regional plans	$125 - $395

Government programs also on file: Medicare, Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 193), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 71250.

Insurance Before you use insurance

Call your insurance company to confirm Good Samaritan Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 71250.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Good Samaritan Medical Center

Compare: CT scan, chest (no contrast) at other MA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.