CMS Price Transparency Data
CT scan, chest (no contrast)
Facility: St Charles Madras
Billing Code: 71250 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 71250
- Insurance Median: $560
- Cash Discount Price: $1,867
- vs. Medicare Baseline: 5.24x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at St Charles Madras is $560. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,867. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.24x the Medicare baseline. Located in 470 Ne A Street, Madras, OR.
Cash / Self-Pay
$1,867
Average discount available for prompt cash payment at this facility.
Insurance Median
$560
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: $1,867 (1748%)
Insurance Median: $560 (524%)
Cash: $1,867 (1748% of Medicare)
Ins. Median: $560 (524% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 524% of the Medicare baseline (a markup of 424%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Pacificsource Community Solutions [525] | $103 - $114 | 96% |
| Medicaid / KanCare | $108 - $957 | 101% |
| Otj Dept Of Labor Federal Emp [652] | $156 | 146% |
| Otj Us Department Of Labor [669] | $156 | 146% |
| Auto Allstate Insurance [602] | $194 | 182% |
| Auto American Family Insurance [603] | $194 | 182% |
| Auto Country Insurance Claims [604] | $194 | 182% |
| Auto Dairyland Insurance [617] | $194 | 182% |
| Auto Farmers [605] | $194 | 182% |
| Auto Geico Claims Oregon [606] | $194 | 182% |
| Auto Hartford [612] | $194 | 182% |
| Auto Liberty Mutual Auto Ins [613] | $194 | 182% |
| Auto Mutual Of Enumclaw [610] | $194 | 182% |
| Auto Nationwide Allied Insuranc [601] | $194 | 182% |
| Auto Oregon Mutual [614] | $194 | 182% |
| Auto Progressive [608] | $194 | 182% |
| Auto Safeco Concentra [600] | $194 | 182% |
| Auto State Farm Claims [609] | $194 | 182% |
| Auto Sublimity Insurance [616] | $194 | 182% |
| Auto Travelers Insurance [615] | $194 | 182% |
| Auto Usaa [611] | $194 | 182% |
| Generic Auto [649] | $194 | 182% |
| Generic Workers Comp [699] | $194 | 182% |
| Otj Broadspire Services [670] | $194 | 182% |
| Otj Ccmsi [618] | $194 | 182% |
| Otj Chartis Claims [650] | $194 | 182% |
| Otj City County Ins Services [662] | $194 | 182% |
| Otj Corvel [676] | $194 | 182% |
| Otj Esis West Wc Claims [653] | $194 | 182% |
| Otj Gallagher Bassett [654] | $194 | 182% |
| Otj Hartford [655] | $194 | 182% |
| Otj Intermountain Claims Inc [666] | $194 | 182% |
| Otj Liberty Mutual Wausau Underwriters [671] | $194 | 182% |
| Otj Penser No American [663] | $194 | 182% |
| Otj Pinnacle Risk Mgmt [661] | $194 | 182% |
| Otj Saif [667] | $194 | 182% |
| Otj Sedgwick Cms [660] | $194 | 182% |
| Otj Sedgwick [668] | $194 | 182% |
| Otj Travelers Insurance [672] | $194 | 182% |
| Otj Tristar [673] | $194 | 182% |
| Kaiser Permanente [334] | $230 - $2,021 | 215% |
| Moda [310] | $249 - $2,007 | 233% |
| Providence Health Plan [347] | $249 - $2,042 | 233% |
| Blue Cross Blue Shield | $325 - $616 | 304% |
| Bridgespan [342] | $325 | 304% |
| Asuris Northwest Health [202] | $383 | 359% |
| Healthcare Management Admin [201] | $383 | 359% |
| Regence Group Administrators [203] | $383 | 359% |
| Aetna | $560 - $2,030 | 524% |
| Ageright Advantage [142] | $560 | 524% |
| Champ Va [700] | $560 | 524% |
| Cigna | $560 - $1,470 | 524% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $560 | 524% |
| Devoted Health Inc [145] | $560 | 524% |
| Health Market Care Assured [134] | $560 | 524% |
| Health Net Med Adv [135] | $560 | 524% |
| Humana | $560 | 524% |
| Indian Health [704] | $560 | 524% |
| Kaiser Permanente Med Adv [136] | $560 | 524% |
| Law Enforcement [701] | $560 - $1,158 | 524% |
| Medicare (plans) | $560 - $650 | 524% |
| Samaritan Health Plan Med Adv [141] | $560 | 524% |
| Unicare [133] | $560 | 524% |
| UnitedHealthcare | $560 - $2,157 | 524% |
| Veterans [706] | $560 | 524% |
| Wellcare [132] | $560 | 524% |
| Tricare | $728 | 682% |
| Pacificsource [345] | $933 - $1,277 | 874% |
| Advanced Health [534] | $957 | 896% |
| Allcare Health Plan [538] | $957 | 896% |
| Cascade Health Alliance [532] | $957 | 896% |
| Columbia Pacific Coordinated Care Llc [539] | $957 | 896% |
| Health Share Care Oregon [526] | $957 | 896% |
| Health Share Kaiser [543] | $957 | 896% |
| Health Share Ohsu Ohp [552] | $957 | 896% |
| Health Share Providence [548] | $957 | 896% |
| Health Share [537] | $957 | 896% |
| Intercommunity Health [530] | $957 | 896% |
| Jackson Care Connect [542] | $957 | 896% |
| Primary Health Of Jospehine County Llc [547] | $957 | 896% |
| Umpqua Health [533] | $957 | 896% |
| Willamette Valley Community Health [536] | $957 | 896% |
| Yamhill County Coordinated Care Org [550] | $957 | 896% |
| Us Benefits [326] | $1,470 | 1376% |
| Rocky Mountain Administrators [405] | $1,867 | 1748% |
| Rx Internal [4100003] | $1,907 | 1785% |
| First Choice Health [317] | $2,021 | 1892% |
| Samaritan [376] | $2,021 | 1892% |
| Meritain Health [300] | $2,030 | 1901% |
| Health Net [340] | $2,194 | 2054% |
| Administrative Concepts Inc [402] | $2,287 | 2141% |
| First Health [339] | $2,287 | 2141% |
| Manhattan Life Insurance Company [379] | $2,287 | 2141% |
| Philadelphia American Life Insurance Company [395] | $2,287 | 2141% |
| Planned Administrators Inc [375] | $2,287 | 2141% |