CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Prosser Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $605
Cash Discount Price: $1,310
vs. Medicare Baseline: 5.66x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Prosser Memorial Hospital is $605. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,310. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.66x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$1,310

Average discount available for prompt cash payment at this facility.

Insurance Median

$605

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: $1,310 (1226%)

Insurance Median: $605 (566%)

Cash: $1,310 (1226% of Medicare)

Ins. Median: $605 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Community Health Plan Of Washington	$29 - $979	27%
Coordinated Care	$29 - $979	27%
Kaiser Permanente	$29 - $2,200	27%
UnitedHealthcare	$29 - $1,355	27%
Molina	$30 - $979	28%
Amerigroup	$31 - $1,038	29%
Health Alliance Northwest	$57 - $604	53%
Humana	$57 - $2,055	53%
Wellcare	$57 - $604	53%
Aetna	$58 - $2,055	54%
Cigna	$69 - $1,983	65%
Premera	$69 - $1,934	65%
Asuris	$83 - $2,176	78%
Health Management Adminstrators	$83 - $2,176	78%
Regence	$83 - $2,176	78%
Ambetter / Centene	$103 - $1,862	96%
Multiplan	$205 - $2,176	192%
First Choice	$2,025 - $2,055	1896%

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 $1,310.
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 Prosser Memorial 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.