CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Grossmont Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,255
Cash Discount Price: $3,036
vs. Medicare Baseline: 9.25x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Grossmont Hospital is $2,255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,036. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.25x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$3,036

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,255

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: $3,036 (1245%)

Insurance Median: $2,255 (925%)

Cash: $3,036 (1245% of Medicare)

Ins. Median: $2,255 (925% 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 925% of the Medicare baseline (a markup of 825%). 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
County Medical Services	$567	233%
Managed Health Network	$1,133 - $1,202	465%
Molina	$1,133 - $2,834	465%
Allianz Global Assistance	$1,202 - $2,024	493%
Blue Cross Blue Shield	$1,202 - $2,255	493%
Health Net	$1,202 - $2,834	493%
Aetna	$1,376 - $2,469	564%
Indian Health Council	$1,376	564%
San Diego Pace	$1,376	564%
Kaiser	$2,287 - $2,834	938%
Humana	$2,469	1013%
Community Health Group	$2,570	1054%
Medi-Cal	$2,834	1163%
Epic Americas	$3,036	1245%
UnitedHealthcare	$3,036 - $3,643	1245%
Blue Shield	$3,238	1328%
Interplan	$3,643	1494%

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 $3,036.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.