CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: United Memorial Medical Center

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $127
Cash Discount Price: $458
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at United Memorial Medical Center is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $458. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.19x the Medicare baseline. Located in 127 North Street, Batavia, NY.

Cash / Self-Pay

$458

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $458 (429%)

Insurance Median: $127 (119%)

Cash: $458 (429% of Medicare)

Ins. Median: $127 (119% 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
Excellus Hmo [104]	$85	80%
Excellus Indemnity [127]	$85 - $288	80%
Mvp [109]	$85 - $442	80%
Fidelis Care New York [112]	$98 - $331	92%
Molina Healthcare Of Ny [188]	$106 - $191	99%
UnitedHealthcare	$106	99%
Aetna	$127	119%
Fidelis Exchange [157]	$127 - $191	119%

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 $458.
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 United Memorial 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.