CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Essentia Health Ada

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $1,192
  • Cash Discount Price: $1,339
  • vs. Medicare Baseline: 11.16x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Essentia Health Ada is $1,192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,339. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.16x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$1,339

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,192

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: $1,339 (1254%)
Insurance Median: $1,192 (1116%)
Cash: $1,339 (1254% of Medicare)
Ins. Median: $1,192 (1116% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1116% of the Medicare baseline (a markup of 1016%). 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.

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
Itasca Med Care $106 99%
Primewest $106 99%
Healthpartners Care Pmap $705 660%
Medica Access $721 - $1,129 675%
Sanford Health Plan $777 - $818 727%
Advocare/Security Health $870 815%
Blue Cross Blue Shield $870 - $1,579 815%
Freedom Blue Ppo $870 815%
Healthpartners Care Msho / Mcr Adv $870 815%
Imcare Msho Pcc Prime $870 815%
Imcare Msho Ref Req $870 815%
Medica Advantage Solutions $870 815%
Medica Msho/Dual Solutions $870 815%
Medica Prime Solution Group $870 815%
Medicare (plans) $870 815%
Nd Va Administration $870 815%
Platinum Blue/Vantage Blue $870 815%
Primewest Msho $870 815%
Secure Blue Msho $870 815%
Ubh Cost Plan $870 815%
Ubh Msho $870 815%
Ucare Msho $870 815%
UnitedHealthcare $870 - $1,640 815%
Blue Plus Pmap Pcc Prime $997 - $1,579 933%
Healthpartners $1,102 - $1,205 1032%
Ucare $1,192 1116%
Cigna $1,205 1128%
Healthpartners Pcc Prime $1,205 1128%
Wea $1,305 - $1,395 1222%
America'S Ppo $1,404 1314%
Wps $1,504 - $1,522 1408%
Medica $1,506 - $1,586 1410%
Medica Uplan $1,506 1410%
Aetna $1,540 1442%
Medica Choice $1,633 1529%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals