CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Cheshire Medical Center

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $274
Cash Discount Price: $454
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Cheshire Medical Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $454. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.57x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$454

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $454 (425%)

Insurance Median: $274 (257%)

Cash: $454 (425% of Medicare)

Ins. Median: $274 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Aetna	$51 - $1,879	48%
Ambetter / Centene	$53 - $99	50%
Blue Cross Blue Shield	$53 - $2,182	50%
Cigna	$53 - $1,360	50%
Martin'S Point Generations Advantage	$53 - $111	50%
Martin'S Point Health Care	$53 - $111	50%
Mvp	$53 - $1,360	50%
UnitedHealthcare	$53 - $2,085	50%
Wellcare Health Plans	$53 - $111	50%
Wellsense Health Plan	$53 - $379	50%
Amerihealth Caritas Nh	$66 - $336	62%
Granite State Health Plan	$90 - $459	84%
Mass General Brigham Health Plan	$106 - $2,747	99%
Harvard Pilgrim Health Care Of Ne	$115 - $1,249	108%
Tufts Health Plan	$150 - $1,753	140%
Maine Community Health Options	$243 - $1,236	228%
First Health/Hcvm	$459 - $2,335	430%
Phcs	$486 - $2,472	455%

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 $454.
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 Cheshire Medical Center 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.