CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Adventist Health St Helena

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $3,212
  • Cash Discount Price: $1,087
  • vs. Medicare Baseline: 13.18x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Adventist Health St Helena is $3,212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,087. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.18x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.
Cash / Self-Pay
$1,087

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,212

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $1,087 (446%)
Insurance Median: $3,212 (1318%)
Cash: $1,087 (446% of Medicare)
Ins. Median: $3,212 (1318% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1318% of the Medicare baseline (a markup of 1218%). 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
Cigna $39 - $8,114 16%
Blue Shield Bh Mcr Adv $75 - $317 31%
Blue Shield Mcr Adv $75 - $317 31%
Kaiser Mcr Adv $75 - $317 31%
Tricare $75 - $317 31%
Ah Employee Health Plan - All Plans $82 - $571 34%
Interplan-All Plans $90 - $6,085 37%
Kaiser-All Other Plans $90 - $8,316 37%
Western Growers-All Plans $111 - $5,375 46%
Blue Shield Epn-All Other Plans $136 - $4,777 56%
Blue Shield Non-Epn $144 - $4,706 59%
Phcs-All Plans $168 - $5,578 69%
Medi-Cal $190 78%
Health Management Network-All Plans $259 - $8,621 106%
Three Rivers-All Plans $274 - $9,128 112%
UnitedHealthcare $286 - $6,466 117%
Va Mcr - All Other Plans $317 130%
Va Medi-Cal $439 180%
Aetna $487 - $2,030 200%
Blue Cross Blue Shield $1,569 - $2,092 644%
Healthnet-All Plans $1,725 708%
Blue Shield Behav Hlth $3,260 - $4,564 1337%
Choicecare-All Plans $5,072 - $7,099 2081%
Beech Street-All Plans $5,434 - $7,606 2229%
Galaxy Network-All Plans $6,520 - $9,128 2675%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals