CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Mainehealth Franklin Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $210
Cash Discount Price: $1,430
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Mainehealth Franklin Hospital is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,430. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.97x the Medicare baseline. Located in 111 Franklin Health Commons, Farmington, ME.

Cash / Self-Pay

$1,430

Average discount available for prompt cash payment at this facility.

Insurance Median

$210

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,430 (1339%)

Insurance Median: $210 (197%)

Cash: $1,430 (1339% of Medicare)

Ins. Median: $210 (197% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$51 - $1,091	48%
Blue Cross Blue Shield	$59 - $462	55%
UnitedHealthcare	$59 - $1,275	55%
Wellcare	$59 - $442	55%
Multiplan	$93 - $1,344	87%
Harvard Pilgrim Healthcare	$98 - $1,204	92%
Community Health Options	$103 - $1,247	96%
Cigna	$1,197	1121%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,430.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71250.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mainehealth Franklin Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71250.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.