CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Riverside Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $4,356
Cash Discount Price: $20,597
vs. Medicare Baseline: 12.22x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Riverside Community Hospital is $4,356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,597. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 12.22x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$20,597

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,356

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: $20,597 (5779%)

Insurance Median: $4,356 (1222%)

Cash: $20,597 (5779% of Medicare)

Ins. Median: $4,356 (1222% 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 1222% of the Medicare baseline (a markup of 1122%). 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
La Care Health	$317	89%
Molina	$317	89%
Brand New Day	$348	98%
Inland Empire Health Plan	$459	129%
Blue Cross Blue Shield	$527 - $1,726	148%
United	$828 - $6,478	232%
Aetna	$1,850	519%
Medcare Partners	$2,485 - $3,694	697%
Blue Shield	$3,795 - $6,108	1065%
First Health	$7,288 - $22,167	2045%
American Health System	$7,454 - $11,083	2091%
Healthsmart	$13,251 - $19,704	3718%
Multiplan	$13,251 - $20,935	3718%
Next	$13,251 - $19,704	3718%

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 $20,597.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Riverside Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
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.