CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: CHI Health Plainview Hospital

Billing Code: 71250 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$709
about 6.6× the $107 Medicare rate · typically $181–$3,129
modeled estimate · not a bill or quote
Medicare pays $107 Fair price $709 Cash price $2,670 Hospital's list price $3,179

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $1,939 - $3,020 1815%
Blue Cross Blue Shieldmajor $1,939 - $3,020 1815%
Humanamajor $1,939 1815%
Ambetter (Centene) $1,978 - $2,066 1852%
Amerigroup $2,036 1906%
Medica $1,939 - $3,052 1815%
Molina $2,149 2012%
+ 9 smaller / regional plans $1,939 - $4,305
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: P O Box 489, 704 North Third St, Plainview, NE 68769
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals