CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Grossmont Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,413
  • Cash Discount Price: $4,562
  • vs. Medicare Baseline: 9.58x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Grossmont Hospital is $3,413. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,562. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.58x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.
Cash / Self-Pay
$4,562

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,413

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: $4,562 (1280%)
Insurance Median: $3,413 (958%)
Cash: $4,562 (1280% of Medicare)
Ins. Median: $3,413 (958% 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 958% of the Medicare baseline (a markup of 858%). 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
Epic Americas $852 - $4,106 239%
Aetna $912 - $4,136 256%
Humana $912 256%
Health Net $1,703 - $4,562 478%
Molina $1,703 - $3,802 478%
Interplan $1,855 - $3,346 520%
Indian Health Council $2,068 580%
San Diego Pace $2,068 580%
Medi-Cal $2,914 818%
Medicare (plans) $2,920 - $3,346 819%
County Medical Services $3,388 - $5,475 951%
Blue Cross Blue Shield $3,437 - $4,258 964%
Blue Shield $3,437 - $5,961 964%
Kaiser $3,437 964%
Managed Health Network $4,136 1160%
UnitedHealthcare $4,258 1195%
Cigna $4,562 - $5,961 1280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5555 Grossmont Center Drive Box 58, La Mesa, CA 91942
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals