CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Wagoner Community Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $99
Cash Discount Price: $390
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Wagoner Community Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.93x the Medicare baseline. Located in 1200 West Cherokee Street, Wagoner, OK.

Cash / Self-Pay

$390

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $390 (365%)

Insurance Median: $99 (93%)

Cash: $390 (365% of Medicare)

Ins. Median: $99 (93% 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
Medicaid / KanCare	$68 - $71	64%
Humana	$71 - $99	66%
Oklahoma Complete Health - Commercial-Hmo	$71	66%
Aetna	$93	87%
Medicare (plans)	$100	94%
UnitedHealthcare	$100 - $326	94%
Healthchoice - Commercial-Ppo	$225	211%

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 $390.
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 Wagoner Community Hospital 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.