CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Freestone Medical Center

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $1,121
  • Cash Discount Price: $2,616
  • vs. Medicare Baseline: 10.50x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Freestone Medical Center is $1,121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,616. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.50x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
$2,616

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,121

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: $2,616 (2449%)
Insurance Median: $1,121 (1050%)
Cash: $2,616 (2449% of Medicare)
Ins. Median: $1,121 (1050% 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 1050% of the Medicare baseline (a markup of 950%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Gilsbar $97 - $3,736 91%
Blue Cross Blue Shield $127 - $3,363 119%
Mcaid $135 - $785 126%
Misc Mcaid Hmo $135 - $1,121 126%
Superior Health Chip $135 - $785 126%
Tx Childrens Mcaid $135 - $785 126%
UnitedHealthcare $135 - $1,121 126%
Amerigroup $160 - $1,121 150%
Medicaid / KanCare $160 - $1,726 150%
Rightcare S&W Mcaid $160 - $1,121 150%
Superior Health Mcd $160 - $1,726 150%
Aarp $242 227%
Apwu $242 227%
Fringe Benefits $242 227%
Geha $242 227%
Uhcss $242 227%
Aetna $1,302 - $2,989 1219%
Cigna $2,242 2099%
Misc Multiplan $2,616 2449%
Misc Multiplan Auto $2,616 2449%
Misc Multiplan Workcomp $2,616 2449%
Self Pay Gt 083123 $2,616 2449%
Self Pay Lt 090123 $2,616 2449%
Aflac $3,736 3498%
Bankers Life $3,736 3498%
Fairview Nursing Home $3,736 3498%
Humana $3,736 3498%
Icare $3,736 3498%
Inmate Freestone Co $3,736 3498%
Misc Hospice $3,736 3498%
Miscellaneous $3,736 3498%
Miscellaneous Auto $3,736 3498%
Mutual Of Omaha $3,736 3498%
North American Med Empl $3,736 3498%
Standard Life Insurance $3,736 3498%
Tml $3,736 3498%
Zelis Healthcare $3,736 3498%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals