CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Sisters of Charity Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $111
  • Cash Discount Price: $312
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Sisters of Charity Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $312. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.04x the Medicare baseline. Located in 2157 Main Street, Buffalo, NY.
Cash / Self-Pay
$312

Average discount available for prompt cash payment at this facility.

Insurance Median
$111

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: $312 (292%)
Insurance Median: $111 (104%)
Cash: $312 (292% of Medicare)
Ins. Median: $111 (104% 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.

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
UnitedHealthcare $35 - $173 33%
Medicaid / KanCare $41 - $199 38%
VA Veterans Affairs [700001] $42 - $111 39%
Univera Healthcare Essential [100170] $43 - $170 40%
Univera Healthcare [100169] $43 - $161 40%
Beacon Essential [350122] $44 - $157 41%
Independent Health Essential [100166] $45 - $199 42%
Vna Option Mltc [350110] $45 - $199 42%
Tuscarora Nation [550120] $45 - $199 42%
Crime Victims [100176] $45 - $199 42%
Excellus Rochester McD [350117] $45 - $199 42%
Ghi [100153] $47 - $124 44%
Hospice [550001] $49 - $131 46%
Seneca Nation [450119] $49 - $131 46%
Covid19 Hrsa [45013] $49 - $131 46%
Fallon Health [450115] $49 - $131 46%
Cigna $49 - $189 46%
Champ VA [700002] $49 - $131 46%
Tricare $49 - $131 46%
Medicare (plans) $49 - $188 46%
Catholic Health Life Pace [400005] $49 - $131 46%
Wellcare Fidelis Dual [450451] $52 - $137 49%
Aetna $52 - $137 49%
Humana $52 - $137 49%
Fidelis Dual Advantage [450120] $52 - $137 49%
Fidelis Essential [100163] $54 - $318 51%
Iha First Choice [800001] $54 - $308 51%
Wellcare [450129] $54 - $144 51%
Independent Health [100165] $54 - $311 51%
Blue Cross Blue Shield $58 - $318 54%
Fidelis Exchange [100164] $59 - $157 55%
Beacon Health Options [100023] $59 - $157 55%
Mvp Healthcare [100168] $72 - $192 67%
Amerigroup [350102] $74 - $239 69%
UPMC Health Plan [100181] $89 - $235 83%
Molina Essential [100167] $101 - $448 95%
Federal Workers Compensation [500100] $129 - $514 121%
No Fault [114001] $129 - $514 121%
Workers Compensation [500101] $129 - $514 121%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2157 Main Street, Buffalo, NY 14214
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals