CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Newton Medical Center

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $257
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 2.41x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Newton Medical Center is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 175 High St, Newton, NJ.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $116 (109%)
Insurance Median: $257 (241%)
Cash: $116 (109% of Medicare)
Ins. Median: $257 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
VA Community Care Network [5403] $116 109%
Tricare $116 109%
Wellcare Health Plans [5269] $116 109%
UPMC [5455] $116 109%
Fairos [5491] $116 109%
Cigna $116 - $240 109%
Sedgwick Wtc Health Program Wc [5514] $116 109%
Luminare Health AHS Retiree [5013] $116 109%
Us Family Health Plan [5258] $116 109%
Medicare (plans) $116 - $120 109%
Blue Cross Blue Shield $116 - $5,379 109%
Karen Ann Quinlan [5285] $116 109%
Highmark Wholecare Health Plan [5413] $116 109%
Wellcare Behavioral Health [5335] $116 109%
Ambetter / Centene $116 109%
Cosmetic Surgery/Lap Band/Gastric Bypass [5289] $116 109%
Highmark Wholecare Health Plan Ip Splits [5464] $116 109%
Aetna $116 - $642 109%
Wellcare Health Plans Ip Splits [5475] $116 109%
Claimdoc [5434] $116 109%
Amerihealth Administrators Supplemental [5512] $116 109%
Medicaid / KanCare $116 - $612 109%
Champva [5354] $116 109%
Claim Watcher/Homestead [5488] $116 - $3,961 109%
Specialty Imaging [5433] $116 109%
Amerihealth Medigap [5049] $116 109%
Amerihealth Caritas Vip Care Ip Splits [5460] $117 110%
Amerihealth Caritas Vip Care [5313] $117 110%
Kindred Giralda Hospital [5341] $128 120%
One Call Workers Comp [5418] $152 142%
Carisk Worker's Comp [5501] $160 150%
Surest [5437] $178 167%
Harvard Pilgrim Healthcare [5133] $178 167%
Ntca [5208] $178 167%
Oxford [5024] $178 167%
UnitedHealthcare $178 167%
Oxford Behavioral Health [5291] $178 167%
Golden Rule Insurance [5124] $178 167%
Apwu Healthcare [5053] $178 167%
Geha [5119] $178 167%
Webtpa [5447] $218 - $642 204%
Nalc [5198] $218 204%
Evolution Healthcare [5438] $218 - $642 204%
Healthez [5445] $218 - $642 204%
Seafarers Health and Benefits Plan [5343] $218 204%
Mvp Health Care [5197] $218 204%
Tufts Health Plan [5344] $218 204%
First Managed Care Option [5109] $226 - $6,734 212%
Independence Bc [5479] $238 223%
Prime Healthcare [5435] $238 223%
Centivo [5405] $238 - $240 223%
Allied Benefit Systems [5046] $240 - $642 225%
Iaa - Insurance Administrators of America [5482] $240 225%
Wtc Health Program [5273] $257 241%
Qualcare [5026] $258 - $936 242%
Inservco Workers Compensation [5158] $303 - $6,734 284%
Medlogix/Consumer Health Network (Chn) [5415] $303 - $6,734 284%
Sedgwick [5235] $383 359%
Pma Workers Comp [5224] $383 359%
Gallagher Bassett Workers Comp [5117] $383 359%
Sentry Worker's Comp [5489] $383 359%
Liberty Mutual Worker's Comp [5174] $383 359%
Travelers Workers Compensation [5250] $383 359%
Praxis Workers Comp [5515] $400 - $5,942 374%
Occunet [5490] $424 397%
The Fairly Group [5528] $424 397%
Horizon Nj Health [5021] $495 463%
Untd Hlth Community Plan Behavioral Health [5293] $585 548%
Untd Hlth Community Plan [5034] $585 548%
Nippon Benefit Life [5201] $642 601%
Christian Brothers Services [5439] $642 601%
Marpai Health [5449] $642 601%
Banner Health Network [5510] $642 601%
Boon-Chapman [5441] $642 601%
1199 Seiu Benefit and Pension [5037] $642 601%
Starmark [5240] $642 601%
Continental Assurance [5091] $642 601%
Healthsmart Benefit Solutions [5446] $642 601%
Meritain Health [5185] $642 601%
Luminare Health Benefits [5483] $642 601%
Medlogix/Consumer Health Network Pip (Chn) [5414] $764 715%
Plymouth Rock Assurance No Fault [5222] $764 715%
High Point No Fault [5146] $764 715%
Ghi Emblem Health [5122] $936 876%
Oscar [5213] $936 876%
Humana $936 876%
Ila Local 1478-2 Welfare Fund [5448] $936 876%
Magnacare [5177] $1,235 - $6,338 1156%
Amerihealth [5008] $4,278 4005%
Private Healthcare Systems PPO (PHCS) [5227] $4,357 4079%
Continental Assurance - PHCS [5092] $4,357 4079%
Kaiser Permanente [5162] $4,357 4079%
Continental Casualty PHCS [5094] $4,357 4079%
Coresource [5014] $4,357 4079%
Hanover Workers Comp [5130] $4,468 4183%
Selective Ins Workers Comp [5237] $4,468 4183%
Church Mutual Wc Insurance Company [5524] $4,468 4183%
Hcs Network Solutions [5148] $4,468 4183%
Nj Manufacturers Workers Comp [5204] $4,468 4183%
Zurich Workers Comp [5275] $4,468 4183%
Strategic Comp [5518] $4,468 4183%
Hartford Worker's Compensation [5132] $4,468 4183%
Progressive No Fault [5229] $4,729 4427%
Usaa No Fault [5260] $4,729 4427%
Geico No Fault [5120] $4,729 4427%
Hanover No Fault [5129] $4,729 4427%
Esurance No Fault [5105] $4,729 4427%
Allstate [5047] $4,729 4427%
Nj Manufacturers No Fault [5203] $4,729 4427%
Liberty Mutual No Fault [5173] $4,729 4427%
Zurich No Fault [5274] $4,729 4427%
State Farm No Fault [5241] $4,729 4427%
Travelers No Fault [5249] $4,729 4427%
Occunet Secondary [5517] $4,753 4450%
The Fairly Group Secondary [5531] $4,753 4450%
First Health Network [5108] $5,149 4821%
Multiplan [5194] $5,545 5191%
Qual-Lynx Wc Preferred [5230] $5,942 5563%
Berkshire Hathaway Guard Insurance Company [5529] $5,942 5563%
Amtrust North America Inc [5521] $5,942 5563%
Broadspire Workers Comp [5357] $5,942 5563%
Sage Adjusting, LLC [5527] $5,942 5563%
Aig Workers Compensation [5045] $5,942 5563%
Nationwide Mutual Insurance Company [5526] $5,942 5563%
Ccmsi Wc [5525] $5,942 5563%
Qual-Lynx Wc Standard [5028] $5,942 5563%
Esis [5519] $6,734 6305%
Corvel Corporation [5522] $6,734 6305%
Claims Resolution Corporation Inc [5520] $6,734 6305%
Chubb Worker's Compensation [5075] $6,734 6305%
Medrisk/Spnet Worker's Comp [5452] $6,734 6305%
Carba R Generic [5530] $7,922 7417%
Bundled Cases/Episodic Payment [5492] $7,922 7417%
Atlantic Home Care and Hospice [5055] $7,922 7417%
Kessler Foundation [5532] $7,922 7417%
Streamline Worker's Comp [5540] $7,922 7417%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 175 High St, Newton, NJ 07860
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals