CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $204
  • Cash Discount Price: $987
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Memorial Hospital is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $987. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.91x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.
Cash / Self-Pay
$987

Average discount available for prompt cash payment at this facility.

Insurance Median
$204

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: $987 (924%)
Insurance Median: $204 (191%)
Cash: $987 (924% of Medicare)
Ins. Median: $204 (191% 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
Meridian Health Plan Of Mi $57 - $571 53%
Paramount Healthcare Inc $96 - $851 90%
Aetna $97 - $954 91%
Blue Cross Blue Shield $97 - $557 91%
Humana $97 - $571 91%
Molina Healthcare Of Ohio $97 - $879 91%
Summacare $97 - $835 91%
Health Alliance Plan $99 - $987 93%
Buckeye Community Health Plan $122 - $422 114%
Frontpath $122 - $928 114%
Caresource $124 - $557 116%
UnitedHealthcare $134 - $754 125%
Cigna $139 - $1,059 130%
Health Ohio Network $169 - $1,048 158%
Amerihealth $204 - $581 191%
Multiplan $360 - $1,367 337%
Medical Mutual Of Ohio $397 - $1,015 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 715 South Taft Avenue, Fremont, OH 43420
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals