CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: San Antonio Regional Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $773
  • Cash Discount Price: $1,461
  • vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at San Antonio Regional Hospital is $773. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,461. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.17x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$1,461

Average discount available for prompt cash payment at this facility.

Insurance Median
$773

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: $1,461 (410%)
Insurance Median: $773 (217%)
Cash: $1,461 (410% of Medicare)
Ins. Median: $773 (217% 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 217% of the Medicare baseline (a markup of 117%). 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 $440 123%
Blue Shield Mcr Adv $449 126%
Caremore Mcr Adv - All Plans $449 126%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $449 126%
Healthnet Mcr Adv $449 126%
Humana $449 126%
Iehp Mcr Adv $449 126%
Inter Valley Hp Mcr Adv- All Plans $449 126%
Kindred Mcr Adv-All Plans $449 126%
Molina Mcr Adv $449 126%
Scan Health Plan Mcr Adv-All Plans $449 126%
Universal Care - All Plans $449 126%
Blue Cross Blue Shield $458 - $8,445 128%
Zelis Mcr Adv $471 132%
Kasiser Mcr Adv $480 135%
Imperial Health Mcr Adv-All Plans $494 139%
Choice Phycn Ntwrk Op Only $561 157%
UnitedHealthcare $566 - $1,579 159%
Molina Exchange-All Other Plans $583 164%
Medi-Cal $594 167%
Pc Inland Valley Scan $600 168%
Pc Inland Valley-All Other Plans $600 168%
Aetna $606 - $15,539 170%
Kaiser Medi-Cal $624 175%
Healthnet Medi-Cal $627 176%
Iehp Comm - All Other Plans $651 183%
Alpha Care Mg Mcal/Hlthy Kids $654 183%
Heritage Prov Ntwrk/Regal Mcal $654 183%
Redlands Employee $673 189%
Molina Medi-Cal $684 192%
Choicecare Ntwrk-All Plans $700 196%
Redlands Hmo-All Other Plans $700 196%
Iehp Mcal $773 217%
Prime Health - All Plans $785 220%
Healthnet - All Other Plans $1,074 301%
Blue Shield Epn $1,169 328%
Kaiser Comm - All Other Plans $1,252 351%
Coventry Ccn/First Hlth - All Plans $1,300 365%
Ambetter / Centene $2,730 766%
Blue Shield Epo Ppo - All Other Plans $3,244 910%
Blue Shield Hmo Pos / Calpers Ppo $3,244 910%
Epic Health Plan - All Other Plans $4,662 1308%
Networks By Design - All Plans $8,574 2406%
Multiplan/Phcs - All Plans $11,188 3139%
Zelis Comm-All Other Plans $11,654 3270%
Foundation Inland Epo-All Other Plans $12,431 3488%
Foundation Inland Ppo $13,208 3706%
Health Payors - All Plans $13,985 3924%
Interplan - All Plans $13,985 3924%
Wellcare/Easy Choice-All Plans $15,228 4272%
Alpha Care Mg Mcr Adv $15,539 4360%
Central Hlth Plan Mcr Adv-All Plans $15,539 4360%
Epic Health Plan Mcr Adv $15,539 4360%
Prospect Hp-All Plans $15,539 4360%
Providence Clevercare Mcr Adv $15,539 4360%
Heritage Prov Ntwrk/Regal Mcr Adv $15,772 4425%
Clever Care Mcr Adv - All Plans $16,316 4578%
La Salle Hp Mcr Adv-All Plans $16,316 4578%
Providence Oscar-All Other Plans $16,316 4578%
Alpha Care Mg-All Other Plans $19,424 5450%
Heritage Prov Ntwrk/Regal - All Other Plans $28,553 8011%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals