CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Ascension Seton Edgar B Davis

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $137
Cash Discount Price: $815
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Ascension Seton Edgar B Davis is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $815. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.28x the Medicare baseline. Located in 130 Hays Street, Luling, TX.

Cash / Self-Pay

$815

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $815 (763%)

Insurance Median: $137 (128%)

Cash: $815 (763% of Medicare)

Ins. Median: $137 (128% 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
Blue Cross Blue Shield	$72 - $501	67%
Dell Star	$72 - $137	67%
UnitedHealthcare	$72 - $137	67%
Wellpoint Star	$72 - $137	67%
Wellpoint Star Plus	$72 - $137	67%
Ambetter / Centene	$107 - $112	100%
Wellpoint Chip/Chip Perinate	$107 - $135	100%
Wellpoint Star Kids	$107 - $135	100%
Champva	$108 - $157	101%
Tricare	$109	102%
Dell Chip/Chip Perinate	$112 - $137	105%
Humana	$162	152%
Seton Performance Plus	$317	297%
Superior Star	$707 - $1,105	662%
Superior Star Foster	$707 - $1,105	662%
Superior Star Kids	$707 - $1,105	662%
Superior Star Plus	$707 - $1,105	662%
Aetna	$777 - $1,345	727%
Superior Chip/Chip Perinate	$796 - $1,243	745%
Covenant Health	$883	827%
Cigna	$1,610	1507%

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 $815.
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 Ascension Seton Edgar B Davis 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.