CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Gundersen Boscobel Area Hospital and Clinics

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $757
Cash Discount Price: $766
vs. Medicare Baseline: 7.09x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Gundersen Boscobel Area Hospital and Clinics is $757. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $766. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.09x the Medicare baseline. Located in 205 Parker St, Boscobel, WI.

Cash / Self-Pay

$766

Average discount available for prompt cash payment at this facility.

Insurance Median

$757

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: $766 (717%)

Insurance Median: $757 (709%)

Cash: $766 (717% of Medicare)

Ins. Median: $757 (709% 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 709% of the Medicare baseline (a markup of 609%). 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
Amerigroup	$46	43%
Blue Cross Blue Shield	$239 - $2,313	224%
Iowa Total Care	$239	224%
Managed Health Service	$239	224%
Humana	$742 - $1,287	695%
Ucare	$742 - $1,211	695%
Cigna	$1,241	1162%
Aspirus Arise Health	$1,257	1177%

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 $766.
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 Gundersen Boscobel Area Hospital and Clinics 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.