CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $1,275
Cash Discount Price: $869
vs. Medicare Baseline: 11.94x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Carilion Stonewall Jackson Hospital is $1,275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $869. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.94x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.

Cash / Self-Pay

$869

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,275

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: $869 (814%)

Insurance Median: $1,275 (1194%)

Cash: $869 (814% of Medicare)

Ins. Median: $1,275 (1194% 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 1194% of the Medicare baseline (a markup of 1094%). 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
Aetna	$92 - $1,648	86%
Humana	$94 - $128	88%
Blue Cross Blue Shield	$100 - $488	94%
UnitedHealthcare	$101 - $2,029	95%
Sentara Health Plan	$103 - $1,539	96%
Abh of VA (Formerly Coventry)	$128	120%
Abh of Wva (Formerly Coventry)	$128	120%
Gateway - Tier 3	$1,365	1278%
Vhn - Ultra	$1,539	1441%
Connecticare	$1,737	1626%
Gateway - Tier 2	$1,986	1859%
Vhn - Plus	$1,986	1859%
Cigna	$1,988	1861%
Integrated Health Plan	$2,110	1975%
Vhn	$2,110	1975%
Vhn - Link	$2,234	2092%
Beech Street	$2,283	2137%
Gateway - Tier 1	$2,358	2208%
Vhn - Secondary Payors	$2,358	2208%

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 $869.
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 Carilion Stonewall Jackson Hospital 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.