CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: City of Hope National Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,872
Cash Discount Price: $4,103
vs. Medicare Baseline: 8.06x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at City of Hope National Medical Center is $2,872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,103. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.06x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$4,103

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,872

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: $4,103 (1151%)

Insurance Median: $2,872 (806%)

Cash: $4,103 (1151% of Medicare)

Ins. Median: $2,872 (806% 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 806% of the Medicare baseline (a markup of 706%). 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
Health Net	$221 - $3,980	62%
Cal Optima	$249 - $1,359	70%
Heritage Provider Network	$312 - $2,872	88%
Inland Empire	$312 - $3,282	88%
Prime Healthcare Keenan	$436 - $3,939	122%
Healthcare Partners	$760	213%
Aetna	$1,093	307%
UnitedHealthcare	$1,932 - $2,298	542%
Blue Cross Blue Shield	$2,052 - $6,237	576%
Blue Shield	$2,429 - $4,891	681%
Blue Shield Covca	$2,495	700%
Blue Shield Promise	$2,872	806%
Cencal	$3,282	921%
La Care Health	$3,282	921%
Kaiser	$3,693	1036%
Gold Coast	$4,103	1151%
Molina	$4,103 - $5,334	1151%
Cigna	$4,407	1236%
Facey	$4,513	1266%
St. Joseph Heritage	$4,924	1381%
Primecare Medical Network	$5,334	1497%
First Health	$6,319	1773%
Phcs Multiplan	$7,385	2072%

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 $4,103.
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 City of Hope National Medical Center 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.