CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: UPMC Hamot

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $821
Cash Discount Price: $3,284
vs. Medicare Baseline: 7.69x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at UPMC Hamot is $821. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,284. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.69x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$3,284

Average discount available for prompt cash payment at this facility.

Insurance Median

$821

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: $3,284 (3075%)

Insurance Median: $821 (769%)

Cash: $3,284 (3075% of Medicare)

Ins. Median: $821 (769% 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 769% of the Medicare baseline (a markup of 669%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Fidelis	$117	110%
Aetna	$119 - $3,831	111%
Upmc Health Plan	$119 - $515	111%
Wellcare	$121	113%
Blue Cross Blue Shield	$122 - $1,562	114%
UnitedHealthcare	$125 - $693	117%
Amerihealth Caritas	$126 - $209	118%
Cigna	$126 - $2,189	118%
Highmark Wholecare (Prev Gateway)	$126 - $2,736	118%
Pa Health & Wellness	$126 - $228	118%
Independent Health	$166 - $222	155%
Geisinger	$186	174%
Health Partners Plans (Jefferson Health Plan)	$201	188%
Upmc Work Partners	$701	656%
Univera	$821 - $2,408	769%
Intergroup	$3,557 - $4,378	3330%
Multiplan	$3,831 - $4,378	3587%

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 $3,284.
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 UPMC Hamot 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.