CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Pender Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $613
Cash Discount Price: $762
vs. Medicare Baseline: 5.74x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Pender Memorial Hospital is $613. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $762. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.74x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$762

Average discount available for prompt cash payment at this facility.

Insurance Median

$613

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: $762 (713%)

Insurance Median: $613 (574%)

Cash: $762 (713% of Medicare)

Ins. Median: $613 (574% 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 574% of the Medicare baseline (a markup of 474%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$220 - $638	206%
Humana	$426 - $1,486	399%
Pace Of The Southern Piedmont	$448 - $467	419%
New Hanover Health	$457 - $476	428%
Aetna	$459 - $1,469	430%
Cigna	$462 - $762	433%
Carolina Complete	$466 - $485	436%
Nc Department Of Public Safety	$466 - $933	436%
Amerihealth	$476 - $495	446%
Wellcare	$476 - $495	446%
Ambetter / Centene	$627 - $653	587%
Liberty Health	$637 - $663	596%
Caresource North Carolina	$664 - $691	622%
Plotkin Health	$996 - $1,037	932%
UnitedHealthcare	$1,212 - $1,261	1135%
Medcost	$1,250 - $1,450	1170%
Employers Choice Network	$1,610 - $1,676	1507%
Three Rivers Provider Network	$1,610 - $1,676	1507%

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 $762.
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 Pender Memorial 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.