CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Union Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $161
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Union Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.51x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$161

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: $441 (413%)
Insurance Median: $161 (151%)
Cash: $441 (413% of Medicare)
Ins. Median: $161 (151% 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
Summacare $31 - $326 29%
Aetna $48 - $679 45%
Blue Cross Blue Shield $48 - $362 45%
Cigna $48 - $306 45%
Humana $48 - $98 45%
The Health Plan $48 - $584 45%
United $48 - $335 45%
Valor $48 - $98 45%
Mmo $50 - $441 47%
Aultcare $51 - $306 48%
Communicare $51 - $103 48%
Perennial Health $52 - $106 49%
Pphp $52 - $108 49%
Zing Health $53 - $108 50%
Cc Ehp $54 - $507 51%
Devoted Health $98 92%
UnitedHealthcare $98 92%
Upmc $98 - $407 92%
Oscar $124 - $261 116%
Buckeye $161 151%
Caresource $161 151%
Molina $169 158%
Amerihealth $177 166%
Ohcp $181 - $330 169%
Omas $232 - $340 217%
Healthsmart $256 - $373 240%
Phphi $279 - $407 261%
Amish Community Aid Plan $306 - $340 286%
Gms $326 - $475 305%
Consociate Health $349 - $509 327%
Ohio Healthy $367 344%
Php $407 381%
Multiplan $418 - $611 391%
Medical Benefit Corp $475 445%
Frontpath $611 572%
Managed Care Services $611 572%
Tertiary Care Network $611 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals