CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Valley Presbyterian Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,087
Cash Discount Price: $4,348
vs. Medicare Baseline: 3.05x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Valley Presbyterian Hospital is $1,087. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,348. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.05x the Medicare baseline. Located in 15107 Vanowen St, Van Nuys, CA.

Cash / Self-Pay

$4,348

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,087

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: $4,348 (1220%)

Insurance Median: $1,087 (305%)

Cash: $4,348 (1220% of Medicare)

Ins. Median: $1,087 (305% 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 305% of the Medicare baseline (a markup of 205%). 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
Blue Shield Senior	$445	125%
Aetna	$454 - $2,485	127%
Blue Cross Blue Shield	$454 - $1,945	127%
Health Net Senior	$454	127%
La Care Covered California	$454	127%
Medicare (plans)	$454 - $476	127%
Ambetter / Centene	$640	180%
Heritage Provider Network (Regal & Lakeside)	$703	197%
Health Net	$760 - $897	213%
Cigna	$957	268%
Blue Shield Promise Medi-Cal	$1,087	305%
UnitedHealthcare	$1,367 - $3,383	384%
La Care Medi-Cal	$2,609	732%
Phcs	$2,609	732%
Coventry Health Care (Ccn)	$3,044	854%
Beech Street	$3,261	915%
Blue Shield Ifp	$3,542	994%
Multiplan	$3,913	1098%
Blue Shield	$4,207	1180%

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 $4,348.
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 Valley Presbyterian 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.