CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Black River Memorial Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $959
Cash Discount Price: $924
vs. Medicare Baseline: 8.98x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Black River Memorial Hospital is $959. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $924. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.98x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$924

Average discount available for prompt cash payment at this facility.

Insurance Median

$959

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: $924 (865%)

Insurance Median: $959 (898%)

Cash: $924 (865% of Medicare)

Ins. Median: $959 (898% 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 898% of the Medicare baseline (a markup of 798%). 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
Humana	$48 - $2,019	45%
UnitedHealthcare	$48 - $2,047	45%
Blue Cross Blue Shield	$50 - $1,107	47%
Group Health Cooperative Of Eau Claire	$53 - $2,106	50%
My Choice Wisconsin, Inc.	$53 - $1,107	50%
Quartz Health Solutions, Inc	$53 - $1,976	50%
Security Health Plan	$63 - $2,028	59%
The Alliance	$63 - $2,084	59%
Multiplan	$190 - $2,149	178%
Corvel	$603 - $1,324	565%
Triology Health Solutions	$890 - $2,062	833%
Medica	$924 - $2,028	865%
Association Benefits Solution	$940 - $2,062	880%
Family Health Center Of Marshfield	$940 - $2,062	880%
First Health Group Corporation	$940 - $2,062	880%
Provider Network Of America	$940 - $2,062	880%
Cigna	$959 - $2,106	898%
Cofinity	$959 - $2,106	898%
Coventry Health Care	$959 - $2,106	898%
Custom Benefit Administrators	$959 - $2,106	898%
Healthpartners, Inc.	$959 - $2,106	898%
Wisconsin Physicians Service Insurance Corp	$959 - $2,106	898%
Chorus	$969 - $2,128	907%

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 $924.
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 Black River 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.