CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: UPMC Northwest

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $838
Cash Discount Price: $1,226
vs. Medicare Baseline: 7.85x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at UPMC Northwest is $838. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,226. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.85x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.

Cash / Self-Pay

$1,226

Average discount available for prompt cash payment at this facility.

Insurance Median

$838

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: $1,226 (1148%)

Insurance Median: $838 (785%)

Cash: $1,226 (1148% of Medicare)

Ins. Median: $838 (785% 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 785% of the Medicare baseline (a markup of 685%). 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
Upmc Health Plan	$92 - $286	86%
Blue Cross Blue Shield	$101 - $1,033	95%
Aetna	$104 - $1,329	97%
UnitedHealthcare	$106 - $154	99%
Amerihealth Caritas	$109 - $209	102%
Highmark Wholecare (Prev Gateway)	$109 - $198	102%
Pa Health & Wellness	$109 - $228	102%
Upmc Work Partners	$651	609%
Cigna	$818 - $1,329	766%
Intergroup	$1,329 - $3,704	1244%
Coventry/First Health	$1,431	1340%
Health Coalition Partners	$1,472	1378%
Private Health Care Systems	$1,635	1531%
Humana	$1,737	1626%

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 $1,226.
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 Northwest 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.