CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: New London Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $177
Cash Discount Price: $646
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at New London Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $646. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.66x the Medicare baseline. Located in 273 County Road, New London, NH.

Cash / Self-Pay

$646

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $646 (605%)

Insurance Median: $177 (166%)

Cash: $646 (605% of Medicare)

Ins. Median: $177 (166% 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.

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
Amerihealth Caritas Nh	$14 - $720	13%
Granite State Health Plan	$14 - $713	13%
Wellsense Health Plan	$14 - $622	13%
Blue Cross Blue Shield	$49 - $1,119	46%
Martin'S Point Generations Advantage	$49 - $622	46%
Martin'S Point Health Care	$49 - $971	46%
UnitedHealthcare	$49 - $1,105	46%
Wellcare Health Plans	$51 - $622	48%
Aetna	$57 - $1,221	53%
Harvard Pilgrim Health Care Of Ne	$59 - $1,008	55%
Ambetter / Centene	$64 - $622	60%
Cigna	$69 - $1,131	65%
Tufts Health Plan	$977 - $1,017	915%
Coventry	$1,335	1250%
Multiplan	$1,342	1256%

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 $646.
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 New London 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.