CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Oakleaf Surgical Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $104
  • Cash Discount Price: $1,747
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Oakleaf Surgical Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,747. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$1,747

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $1,747 (1636%)
Insurance Median: $104 (97%)
Cash: $1,747 (1636% of Medicare)
Ins. Median: $104 (97% 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.

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 $104 - $1,748 97%
Dean Health Plan $104 97%
Group Health Cooperative Of Eau Claire $104 97%
Healthpartners $104 97%
Humana $104 97%
Medica $104 97%
Quartz Health Solutions $104 97%
Security Health Plan Of Wi $104 - $876 97%
Ucare Wi $104 97%
UnitedHealthcare $104 97%
Alliance $518 485%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital, located at 1000 Oakleaf Way in Altoona, Wisconsin, reports a cash median price of $1,747 for a CT scan of the chest without contrast. While the facility's cash rate is significantly lower than the gross charge of $1,941, it is important to note that commercial insurance plans often pay negotiated rates that exceed the cash price. For instance, Blue Cross Blue Shield has a high-end negotiated rate of $1,748, which is nearly identical to the cash rate, while Alliance charges a flat negotiated rate of $518. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $1,747 directly, especially when their insurance negotiated rates are higher, provided they secure a prompt-pay discount or self-pay classification before the claim is submitted.

The Medicare benchmarking rate for this procedure is $106.81, which serves as the objective baseline for evaluating pricing markups. The cash price of $1,747 represents approximately 16 times the Medicare amount, illustrating the typical markup found in commercial billing structures where administrative overhead and profit margins are factored in. Although specific county and state average data were not provided in the available information, patients are encouraged to verify their specific plan's allowed amount, as some insurers like Dean Health Plan and Group Health Cooperative of Eau Claire have a fixed negotiated rate of $104. To ensure transparency and avoid balance billing, patients should request an itemized bill to review CPT codes and unit costs, and explicitly ask the billing department about prompt-pay discounts or self-pay reductions before scheduling the service.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals