CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health and Rideout

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $5,401
Cash Discount Price: $1,848
vs. Medicare Baseline: 15.15x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health and Rideout is $5,401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,848. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 15.15x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$1,848

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,401

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: $1,848 (518%)

Insurance Median: $5,401 (1515%)

Cash: $1,848 (518% of Medicare)

Ins. Median: $5,401 (1515% 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 1515% of the Medicare baseline (a markup of 1415%). 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
Bc Mcal	$443	124%
Kaiser Mcr Adv	$450	126%
Tricare	$450	126%
UnitedHealthcare	$450 - $7,296	126%
Blue Cross Blue Shield	$455 - $1,657	128%
Kaiser Mcal	$594	167%
Medi-Cal	$594	167%
Ca Health And Wellness- All Plans	$737	207%
Celtic Mcaid-All Plans	$737	207%
Ah Employee Health Plan - All Plans	$810	227%
Healthnet Mcal	$1,474	414%
Healthnet Comm-All Other Plans	$5,401	1515%
Aetna	$5,939	1666%
Kaiser-All Other Plans	$6,384	1791%
Blue Shield Uc Care Members	$6,720	1885%
Cigna	$7,159	2009%
First Health-All Plans	$7,350	2062%
Phcs-All Plans	$7,392	2074%
Interplan-All Plans	$7,560	2121%
Blue Shield-All Other Plans	$7,980	2239%
Multiplan-All Plans	$7,980	2239%
Partnership Hp Mcal -All Plans	$13,860	3889%

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 $1,848.
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 Adventist Health and Rideout 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.