CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sonoma Valley Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $2,589
  • Cash Discount Price: $3,784
  • vs. Medicare Baseline: 10.62x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sonoma Valley Hospital is $2,589. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,784. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.62x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$3,784

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,589

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: $3,784 (1552%)
Insurance Median: $2,589 (1062%)
Cash: $3,784 (1552% of Medicare)
Ins. Median: $2,589 (1062% 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 1062% of the Medicare baseline (a markup of 962%). 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
Tricare $322 132%
Blue Cross Blue Shield $328 - $3,547 135%
Bright Hlth/Brand New Day Mcr Adv $328 135%
Hospice Of Marin-All Plans $328 135%
St Joseph Heritage Hltcare Comm-All Other Plans $328 135%
Veterans Admin-All Plans $328 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $345 142%
Cdcr Prison-All Plans $394 162%
Three Rivers (Trpn)-All Plans $394 162%
Aetna $419 172%
First Health(Coventry)-All Plans $419 172%
Chp - Correctional Health Partners - All Plans $427 175%
Medi-Cal $439 180%
Bright Hlth/Brand New Day - All Other Plands $443 182%
Wellpath - All Plans $459 188%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $591 242%
Canopy Health Solutions-All Other Plans $591 242%
Mcal Mgd Care (Php)-All Plans $724 297%
UnitedHealthcare $893 366%
Comm Care Network(Ccn)-All Plans $1,000 410%
Partnership Healthplan-All Plans $1,537 631%
Healthnet Hmo/Ppo-All Other Plans $2,108 865%
Blue Shield Ppo-All Plans $3,071 1260%
Kaiser-All Plans $3,514 1442%
Integrated Health Plan-All Plans $4,000 1641%
Champus-All Plans $4,325 1774%
Cigna $4,325 1774%
Networks By Design - All Plans $4,325 1774%
Great West-One Health Plan Ppo/Pos-All Plans $4,595 1885%
Phcs/Multiplan/Beech St-All Plans $4,595 1885%
Interplan-All Plans $4,757 1951%
Bps-All Plans $4,865 1996%
Ppo Alliance-All Plans $4,865 1996%
Pref Health Networl(Phn)-All Plans $4,865 1996%
Meritage Medical Network Op Only Mcare $5,406 2218%
Scan Mcare-All Plans $5,406 2218%
St Joseph Heritage Hltcare Mcr Adv $5,406 2218%
Correct Care Integ Health-All Plans $6,487 2661%
Employer Direct Healthcare-All Plans $6,487 2661%
Meritage Medical Network Op Only-All Other Plans $6,812 2794%
Creative Legal Services-All Plans $7,028 2883%
Canopy Op Only $9,731 3992%
Vnpn - All Plans $9,731 3992%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals