CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Wellmont Holston Valley Medical Center

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $167
Cash Discount Price: $532
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Wellmont Holston Valley Medical Center is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.56x the Medicare baseline. Located in 130 West Ravine Road, Kingsport, TN.

Cash / Self-Pay

$532

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $532 (498%)

Insurance Median: $167 (156%)

Cash: $532 (498% of Medicare)

Ins. Median: $167 (156% 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
Aetna	$99 - $1,514	93%
Humana	$99	93%
Managed Medicaire	$99	93%
Medicare (plans)	$99	93%
Sentara Health	$99 - $915	93%
United Mine Workers Of America	$99	93%
UnitedHealthcare	$99 - $3,026	93%
Blue Cross Blue Shield	$101 - $423	95%
Amerigroup	$103	96%
Cigna	$104 - $642	97%
Devoted Health Plan	$104	97%
Molina Healthcare	$104 - $140	97%
Mountain Empire Pace	$104	97%
Nhc Advantage	$104	97%
Wellcare	$105 - $3,545	98%
Optima Health	$137	128%
Ambetter / Centene	$216	202%
Seven Corners, Inc.	$238	223%
Medcost	$1,687	1579%
First Health Coventry	$2,730	2556%

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 $532.
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 Wellmont Holston Valley Medical Center 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.