CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $105
Cash Discount Price: $730
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Ascension Providence Hospital, Southfield and Novi is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $730. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$730

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $730 (683%)

Insurance Median: $105 (98%)

Cash: $730 (683% of Medicare)

Ins. Median: $105 (98% 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
Medicaid / KanCare	$59 - $104	55%
Molina Health	$59 - $60	55%
Blue Caid Michigan	$60	56%
Harbor Health Mcd	$60	56%
Total Health Care	$60	56%
UnitedHealthcare	$60	56%
Amerihealth Vip Care Mcr	$90 - $103	84%
Aetna	$104 - $269	97%
Auto Insurance	$104	97%
Jvhl - Mcr Replacement	$104	97%
Mcr Replacement	$104	97%
Veterans Choice	$104	97%
Humana	$105	98%
Meridian Wellcare	$109	102%
Molina Advantage	$109	102%
Priority Ppo	$112	105%
Ambetter / Centene	$130	122%
Molina Marketplace	$130	122%
Priority Health Hmo	$131	123%
Smart Health	$144	135%
Bc Metro Detroit Epo	$155 - $180	145%
Hap Alliance Health	$166	155%
Hap Hmo Pos	$166	155%
Bc Metro Detroit Hmo	$175 - $180	164%
Bcn Local Network Southeast	$175 - $180	164%
Blue Care Network	$178 - $180	167%
Blue Cross Blue Shield	$178 - $180	167%
Hap Preferred	$195	183%

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 $730.
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 Ascension Providence Hospital, Southfield and Novi 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.