CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Westfield Memorial Hospital Inc

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $127
Cash Discount Price: $902
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Westfield Memorial Hospital Inc is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $902. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.19x the Medicare baseline. Located in 189 E Main St, Westfield, NY.

Cash / Self-Pay

$902

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: $902 (844%)

Insurance Median: $127 (119%)

Cash: $902 (844% 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
Univera	$42 - $161	39%
Amerihealth	$53 - $220	50%
Highmark	$59 - $209	55%
Pennsylvania Health And Wellness	$67 - $200	63%
Geisinger	$73 - $214	68%
UnitedHealthcare	$73 - $291	68%
Cigna	$82 - $212	77%
American Health Plans	$126	118%
Life Pittsburgh	$126	118%
Martin'S Point	$126	118%
Jefferson Health Plans	$127 - $204	119%
Medicare (plans)	$130	122%
Aetna	$131 - $242	123%
Humana	$133	125%
Molina	$137	128%

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 $902.
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 Westfield Memorial Hospital Inc 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.