Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST
Friendship, WI
See all hospitals reporting CPT 71250 →Price type
Moundview Memorial Hospital and Clinics, Inc.’s median price of $1.0k is 224% above the median hospital's median price ($323), higher than 78% of the 2,634 hospitals reporting CPT 71250. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 16 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Anthem medicaid facility · other · outpatient | $295.78 | $295.78 | $295.78 – $295.78 |
| 2 | Anthem medicare hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $885.50 | $885.50 | $885.50 – $885.50 |
| 3 | Ucare dually eligible facility · percent of total billed charges · outpatientfrom % of charges | $885.50 | $885.50 | $885.50 – $885.50 |
| 4 | Ucare msho/minnesota special needs facility · percent of total billed charges · outpatientfrom % of charges | $924.00 | $924.00 | $924.00 – $924.00 |
| 5 | Ucare non-dually eligible facility · percent of total billed charges · outpatientfrom % of charges | $924.00 | $924.00 | $924.00 – $924.00 |
| 6 | UnitedHealthcare all payer appendix facility · other · outpatient | $1,221 | $1,221 | $1,221 – $1,221 |
| 7 | Cigna all products facility · percent of total billed charges · outpatientfrom % of charges | $1,484 | $1,484 | $1,484 – $1,484 |
| 8 | Ucare qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $1,540 | $1,540 | $1,540 – $1,540 |
| 9 | MultiPlan mpi_phcs_healtheos facility · percent of total billed charges · outpatientfrom % of charges | $1,694 | $1,694 | $1,694 – $1,694 |
| 10 | MultiPlan mpi_healtheos wc facility · percent of total billed charges · outpatientfrom % of charges | $1,848 | $1,848 | $1,848 – $1,848 |
| 11 | Anthem state specific facility · other · outpatient | $2,092 | $2,092 | $2,092 – $2,092 |
| 12 | Anthem hmo/pos facility · fee schedule · outpatient | $2,182 | $2,182 | $2,182 – $2,182 |
| 13 | Anthem ppo facility · fee schedule · outpatient | $2,182 | $2,182 | $2,182 – $2,182 |
| 14 | Anthem state specific facility · fee schedule · outpatient | $2,182 | $2,182 | $2,182 – $2,182 |
| 15 | Anthem hmo/pos facility · other · outpatient | $2,202 | $2,202 | $2,202 – $2,202 |
| 16 | Anthem ppo facility · other · outpatient | $2,570 | $2,570 | $2,570 – $2,570 |
Last updated: Jun 27, 2026
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