CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: St Marys Hospital Superior

Billing Code: 71250 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$128

about 1.2× the $107 Medicare rate · typically $106–$702

modeled estimate · not a bill or quote

What this hospital charges insurers

$106

Below the fair price — a good deal

about $22 under the fair price · 1.0× Medicare

Medicare pays $107 Fair price $128 This hospital $106 Cash price $1,339 Hospital's list price $1,812

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $55 Priciest $106

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, chest (no contrast) is about $128 (about 1.2× the $107 Medicare rate). St Marys Hospital Superior charges insurers about $106, or about $1,339 in cash — below the fair price — a good deal. Located in Superior, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$580 - $1,640	543%
Blue Cross Blue Shieldmajor	$580 - $1,455	543%
Aetnamajor	$1,540	1442%
Cignamajor	$1,413 - $1,444	1323%
HealthPartners	$580 - $1,444	543%
Medica	$580 - $1,457	543%
Sanford Health Plan	$777 - $818	727%
Security Health Plan	$580 - $1,395	543%
UCare	$580 - $1,192	543%
+ 13 smaller / regional plans	$106 - $1,558

Government programs also on file: Medicare.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,339), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 71250.

Insurance Before you use insurance

Call your insurance company to confirm St Marys Hospital Superior is in-network.
Ask your insurer whether prior approval is required for CPT code 71250.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Marys Hospital Superior

Compare: CT scan, chest (no contrast) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.