CT Scan of Chest Without Contrast
CPT 71250 is a diagnostic CT scan of the chest without contrast, performed over 600,000 times per year on Medicare beneficiaries. Providers charge an average of $657.30, but Medicare pays only $132.60 in a non-facility setting (5.0x markup). The same scan at a freestanding imaging center costs $200 to $400, compared to $800 to $2,000 at a hospital. A critical billing distinction: if you qualify for lung cancer screening (heavy smokers age 50 to 80), a preventive low-dose CT (71271) is covered at $0 cost-sharing under the ACA, while this diagnostic code (71250) is subject to your normal deductible and coinsurance.
CPT 71250 at a Glance
- Average provider charge: $657.30
- Medicare rate (office/imaging center): $132.60
- Medicare rate (hospital, physician only): ~$50.77
- Typical markup: 5.0x over Medicare office rate
- Freestanding center range: $200 to $400
- Hospital range: $800 to $2,000
- Scan type: CT without contrast (non-enhanced)
- Beneficiaries (2023): 609,518
On this page
How the Medicare Rate Is Calculated
Medicare values every procedure using Relative Value Units (RVUs) across three components, then multiplies by the national conversion factor of $33.4009 (2026). For a chest CT, the practice expense component differs significantly between office and facility settings because the CT scanner and technologist costs are included in the office rate but not the facility rate.
| Component | What It Covers | Office (Non-Facility) | Hospital (Facility) |
|---|---|---|---|
| Work RVU | Radiologist interpretation time and skill | 1.16 | 1.16 |
| Practice Expense RVU | CT scanner, technologist, space, supplies | 2.56 | 0.27 |
| Malpractice RVU | Professional liability insurance | 0.09 | 0.09 |
| Total RVU | 3.81 | 1.52 | |
| x $33.4009 | 2026 conversion factor | $132.60 | $50.77 |
Medicare Rate by State
Medicare adjusts the national rate using Geographic Practice Cost Indices (GPCIs). Because CT imaging has a significant practice expense component, geographic differences are noticeable. The same chest CT pays $92.77 in Arkansas versus $128.15 in Alaska.
Medicare Rate by State (2026)
Medicare adjusts payments by location using Geographic Practice Cost Indices (GPCIs). Select your state to see the adjusted rate.
Sample State Rates (Office/Imaging Center Setting)
| State | Medicare Pays | Avg. Charge | Markup |
|---|---|---|---|
| Texas (Austin) | $106.17 | $657.30 | 6.2x |
| California (Los Angeles) | $114.21 | $657.30 | 5.8x |
| New York (Manhattan) | $114.19 | $657.30 | 5.8x |
| Florida (Fort Lauderdale) | $108.04 | $657.30 | 6.1x |
| Ohio | $98.01 | $657.30 | 6.7x |
| Mississippi | $93.63 | $657.30 | 7.0x |
| Arkansas | $92.77 | $657.30 | 7.1x |
| Alaska | $128.15 | $657.30 | 5.1x |
Rates shown are for the non-facility (office/imaging center) setting using 2026 GPCIs and the $33.4009 conversion factor. The average provider charge of $657.30 is the 2023 national average from CMS utilization data. Actual charges vary by provider.
What Insured Patients Actually Pay for a Chest CT
If you have health insurance, your insurer has a negotiated rate with the imaging facility. For a chest CT, that negotiated rate is typically $150 to $400 at freestanding centers and $500 to $1,200 at hospitals. What you owe depends on your plan design:
| Your Situation | What You Likely Pay | How It Works |
|---|---|---|
| Coinsurance plan (deductible met) | $30 to $120 | 20% of the negotiated rate ($150 to $600) |
| Copay plan (imaging copay) | $50 to $200 | Flat copay for CT scans (varies by plan) |
| High-deductible plan (deductible NOT met) | $150 to $1,200 | Full negotiated rate until your deductible is met |
| Medicare Part B | $26.52 | 20% of the Medicare-approved amount ($132.60) |
| Lung cancer screening (71271, eligible patients) | $0 | Covered as preventive under ACA with no cost-sharing |
Should You Use Insurance or Pay Cash for a Chest CT?
Like MRI, chest CT is a procedure where facility choice dramatically affects your cost. Freestanding imaging centers often advertise cash prices of $200 to $350 for a chest CT without contrast. If your insurance would route you to a hospital where the negotiated rate is $800+, your cost-sharing alone may exceed the cash price at a freestanding center.
When Cash-Pay Wins
- Your deductible is unmet and the hospital negotiated rate exceeds a cash price
- You can find a freestanding center at $200 to $350 cash
- You do not expect significant medical expenses later this year
- Your plan requires prior authorization and scheduling is delayed
When Using Insurance Wins
- You have already met your deductible and owe only 20% coinsurance
- You are close to your out-of-pocket maximum
- Your plan has an in-network freestanding center with low negotiated rates
- You may need follow-up procedures (biopsy, repeat imaging) this year
Common Billing Problems with Chest CT
Screening CT coded as diagnostic (71250 instead of 71271)
If you qualify for lung cancer screening and your doctor intended it as preventive, but the facility codes it as 71250 (diagnostic) instead of 71271 (screening low-dose), you lose your $0 cost-sharing benefit. Check your Explanation of Benefits. If you see code 71250 and the scan was ordered as a routine lung screening, contact the provider's billing department and ask them to resubmit with the correct code (71271) and the appropriate ICD-10 screening diagnosis code (Z87.891).
Hospital facility fee surprise
If your CT is performed at a hospital-owned imaging center, you receive two bills: the radiologist's professional fee (~$51) and the hospital's technical/facility fee (often $500 to $1,500). Before scheduling, ask: "Is this facility hospital-based or freestanding?" Many hospital-owned outpatient imaging centers look identical to independent ones but charge facility fees. The 5x markup ($657 average charge vs $132 Medicare rate) largely reflects these hospital facility charges.
Prior authorization denial
Many insurance plans require prior authorization for CT scans. If authorization is not obtained before the scan, the claim may be denied and you could be billed the full charge. If your CT was denied for lack of prior authorization, ask the ordering physician's office to submit a retroactive authorization request. Many insurers will approve retroactively if the scan was medically appropriate. If denied, you can appeal and argue that the scan was medically necessary regardless of the administrative error.
Incidental findings leading to unnecessary follow-up costs
Chest CTs frequently detect incidental findings (small lung nodules, thyroid nodules, adrenal nodules) that require follow-up imaging but rarely turn out to be significant. Each follow-up scan generates additional charges. If your CT report mentions incidental findings with recommended follow-up, ask your doctor about the actual probability of significance. Many tiny nodules in low-risk patients can be monitored less aggressively per Fleischner Society guidelines, potentially saving you from multiple unnecessary follow-up CTs.
Related Chest Imaging Codes
| Code | Description | Medicare (Office) | Avg. Charge |
|---|---|---|---|
| 71250 | CT chest without contrast | $132.60 | $657.30 |
| 71260 | CT chest with contrast | $157.00 | $780.00 |
| 71271 | Low-dose CT lung cancer screening | $99.00 | $350.00 |
| 71046 | Chest X-ray (2 views) | $22.00 | $75.00 |
| 71275 | CT angiography, chest (pulmonary embolism) | $225.00 | $1,050.00 |
Frequently Asked Questions
How much does a chest CT scan cost without insurance?
Without insurance, a chest CT without contrast (CPT 71250) costs $200 to $2,000 depending on the facility. The national average charge is $657.30. Freestanding imaging centers typically charge $200 to $400, while hospital-based facilities charge $800 to $2,000 for the same scan. Medicare pays $132.60 in a non-facility (office/imaging center) setting.
What is the difference between a screening CT (71271) and a diagnostic CT (71250)?
A screening low-dose CT (CPT 71271) is a preventive test covered at $0 cost-sharing under the ACA for eligible patients (20+ pack-year smoking history, age 50 to 80, currently smoking or quit within the past 15 years). A diagnostic chest CT (CPT 71250) is ordered for symptoms or clinical findings and is subject to your normal deductible and coinsurance. The scan itself is similar, but the coding and cost-sharing rules are completely different. Confirm which code your doctor is ordering.
Why is a chest CT so much cheaper at a freestanding imaging center?
Hospital-based imaging centers add facility fees and administrative overhead that freestanding centers do not. The radiologist reading fee is only about $51, meaning the facility/technical component accounts for over 90% of the total charge. Freestanding centers have lower overhead, simpler billing, and pass those savings to patients. The image quality is identical when the same type of scanner is used.
Does insurance cover a chest CT scan?
Most insurance plans cover diagnostic chest CT scans when ordered by a physician for a medical indication (lung nodule follow-up, infection evaluation, abnormal chest X-ray, staging). Your out-of-pocket cost depends on your plan: with coinsurance you pay 20 to 30% of the negotiated rate after your deductible is met, and if your deductible is not met you may owe $150 to $800. Prior authorization is required by many plans for CT scans. Lung cancer screening CTs (71271) for eligible patients are covered at $0 under the ACA.
Need Help Lowering a Medical Bill?
CareRoute Bill Defense is a done-for-you bill reduction service. We analyze the codes on your bill, identify overcharges and coding errors, and apply negotiation and reduction strategies on your behalf. If you received an imaging bill that seems too high, we can help.
Learn about Bill Defense