CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: St Francis Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $840
  • Cash Discount Price: $4,028
  • vs. Medicare Baseline: 7.86x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at St Francis Memorial Hospital is $840. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,028. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.86x the Medicare baseline. Located in 430 North Monitor St, West Point, NE.
Cash / Self-Pay
$4,028

Average discount available for prompt cash payment at this facility.

Insurance Median
$840

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: $4,028 (3771%)
Insurance Median: $840 (786%)
Cash: $4,028 (3771% of Medicare)
Ins. Median: $840 (786% 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 786% of the Medicare baseline (a markup of 686%). 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
Blue Cross Blue Shield $54 - $3,827 51%
Humana $54 - $1,772 51%
Medica $54 - $3,867 51%
Nebraska Total Care $56 - $1,809 52%
Aetna $57 - $3,867 53%
Good Samaritan Insurance Plan Of Nebraska $57 - $1,861 53%
Molina Healthcare Of Nebraska $57 - $2,014 53%
UnitedHealthcare $1,531 - $3,867 1433%
Midlands Choice $3,867 3620%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monitor St, West Point, NE 68788
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals