CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: St Anthony Community Hospital

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $1,045
Cash Discount Price: $2,089
vs. Medicare Baseline: 9.78x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at St Anthony Community Hospital is $1,045. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,089. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.78x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.

Cash / Self-Pay

$2,089

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,045

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: $2,089 (1956%)

Insurance Median: $1,045 (978%)

Cash: $2,089 (1956% of Medicare)

Ins. Median: $1,045 (978% 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 978% of the Medicare baseline (a markup of 878%). 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
Medicare (plans)	$130 - $139	122%
Tricare	$130	122%
Mvp Gold (McR)	$130	122%
Hamaspik (McR)	$130	122%
Affinity By Molina McR	$136	127%
Emblem	$205 - $390	192%
Emblem Select Care (Exchange)	$240	225%
Aetna	$257 - $286	241%
Emblem Ghi/Hip PPO	$282	264%
Cigna	$334	313%
Mvp Exchange	$354	331%
Geisinger Health Commercial/Exchange	$429	402%
Self-Pay - Cc 30%	$627	587%
Mvp Hmo/Ppo	$689	645%
Cdphp	$1,044	977%
Self-Pay - Cc 50%	$1,044	977%
Blue Cross Blue Shield	$1,346 - $8,313	1260%
Self-Pay	$1,490	1395%
Multiplan	$1,567	1467%
PHCS	$1,567	1467%
Emblem Ghi/Hip Hmo/Epo/Pos	$1,671	1564%
First Health	$1,776	1663%
Magnacare Preferred	$1,880	1760%
Oxford Commercial	$1,931	1808%
Oxford Exchange	$2,532	2371%
UnitedHealthcare	$2,532 - $2,979	2371%
Mvp	$18,190 - $21,438	17030%

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 $2,089.
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 St Anthony Community 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.