CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: San Gabriel Valley Medical Center
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $600
- Cash Discount Price: $2,787
- vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at San Gabriel Valley Medical Center is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,787. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.68x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$2,787
Average discount available for prompt cash payment at this facility.
Insurance Median
$600
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: $2,787 (782%)
Insurance Median: $600 (168%)
Cash: $2,787 (782% of Medicare)
Ins. Median: $600 (168% 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $98 - $2,990 | 27% |
| Facey Medical | $250 | 70% |
| Altamed Health Network | $311 - $442 | 87% |
| Beverly Hospital | $311 - $494 | 87% |
| Brand New Day | $311 - $561 | 87% |
| Emanate Health | $311 - $561 | 87% |
| Healthnet Medi-Cal Non-Contract | $311 | 87% |
| Non Contracting Medi Cal | $311 | 87% |
| Veterans Administration | $314 | 88% |
| La Care Health Plan | $358 - $449 | 100% |
| Care 1St Health Plan | $375 - $600 | 105% |
| Aetna | $442 - $651 | 124% |
| Alignment Health Plan | $442 | 124% |
| Apa/Aco Inc | $442 | 124% |
| Avanti | $442 - $1,367 | 124% |
| Blue Shield Of California | $442 - $10,650 | 124% |
| Central Health Plan | $442 - $1,000 | 124% |
| Health Net | $442 - $4,705 | 124% |
| Health Net Inc | $442 - $1,048 | 124% |
| Humana | $442 | 124% |
| Medicare (plans) | $442 - $464 | 124% |
| Molina Healthcare Of California | $442 - $534 | 124% |
| Pacific Alliance Medical Center | $442 | 124% |
| Pacificare Of California | $442 - $1,477 | 124% |
| Providence Health Network | $442 | 124% |
| Tricare | $442 | 124% |
| Wellcare | $442 | 124% |
| Aids Healthcare Foundation | $449 - $1,800 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx | $449 | 126% |
| Inter Valley Health Plan | $449 | 126% |
| Physicians Healthways | $449 - $1,367 | 126% |
| Self-Pay | $449 | 126% |
| St Vincent Medical Center/Psych | $449 | 126% |
| Ahmc Medi-Cal Reciprocity | $451 | 127% |
| Ahmc Reciprocity | $451 | 127% |
| Chinatown Service Center Pace | $530 | 149% |
| Ahmc Health Self-Insurance Epo | $561 | 157% |
| Knox-Keene Act | $561 | 157% |
| Athens Administrators | $597 | 167% |
| Beech Street | $597 - $7,934 | 167% |
| Other Non Contracting Workers Comp | $597 | 167% |
| UnitedHealthcare | $602 | 169% |
| Affiliated Health Fund | $700 | 196% |
| Pacific Independent Physician Associates | $850 | 238% |
| Healthy Way La | $1,367 | 384% |
| Hollywood Presbyterian Adv Med Mcal | $1,367 | 384% |
| Hollywood Presbyterian Medpoint Mcal | $1,367 | 384% |
| Medicaid / KanCare | $1,367 | 384% |
| Private Pay | $1,825 | 512% |
| Cigna | $2,059 | 578% |
| Community Care Network | $4,928 | 1383% |
| Choicecare Network | $6,063 - $6,943 | 1701% |
| Private Healthcare Systems (Phcs) | $6,063 - $6,943 | 1701% |
| Multiplan | $7,795 - $8,926 | 2187% |
| Ppo Next | $7,795 - $8,926 | 2187% |
| Managed Health Network | $8,661 - $9,918 | 2430% |
| Medi-Cal Sub Acute | $8,661 - $9,918 | 2430% |
| One Legacy | $8,661 - $9,918 | 2430% |
| Other Non Contracted Commercial | $8,661 - $9,918 | 2430% |
| Us Behavioral Health Plan | $8,661 - $9,918 | 2430% |