CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Baldwin Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $764
  • Cash Discount Price: $2,987
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Baldwin Health is $764. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,987. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.14x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$2,987

Average discount available for prompt cash payment at this facility.

Insurance Median
$764

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $2,987 (838%)
Insurance Median: $764 (214%)
Cash: $2,987 (838% of Medicare)
Ins. Median: $764 (214% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 214% of the Medicare baseline (a markup of 114%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Veterans Eval Services $310 87%
Tricare $314 88%
Triwest $324 91%
Blue Cross Blue Shield $326 - $616 91%
Humana $326 91%
Medicare (plans) $326 91%
UnitedHealthcare $326 - $764 91%
Windsor Health Plan $326 91%
Community Hospice $331 93%
Hospice $331 93%
Mercy Medical Hospice $331 93%
Node Champva $331 93%
Node Va $331 93%
Cigna $332 - $1,264 93%
Node Devoted Health Mcr Adv $332 93%
Node Clover Health Mcr Adv $334 94%
Select Health $334 94%
Aetna $335 - $11,201 94%
Node Wellcare Mcr Adv $338 95%
Us Dol $414 116%
Ambetter / Centene $496 139%
First Choice $536 150%
Medicaid / KanCare $697 196%
Alamed $900 253%
Self Pay $2,240 - $3,734 628%
American Employee Alliance $4,978 1397%
Multiplan $7,094 - $10,205 1990%
First Health $9,334 - $10,050 2619%
Multiplan Inc $9,521 2671%
Coventry Work Comp Al $9,732 2730%
One Health $9,956 2793%
Pro America $9,956 2793%
Novanet $10,050 2820%
Alabama Wc $10,578 2968%
Gulf Health $10,578 2968%
Principal Ppo $10,578 2968%
Viva Health $10,578 2968%
National Health $11,201 3143%
Galaxy $11,325 3177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals