CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Watsonville Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $4,160
  • Cash Discount Price: $4,713
  • vs. Medicare Baseline: 11.67x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Watsonville Community Hospital is $4,160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,713. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.67x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$4,713

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,160

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: $4,713 (1322%)
Insurance Median: $4,160 (1167%)
Cash: $4,713 (1322% of Medicare)
Ins. Median: $4,160 (1167% 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 1167% of the Medicare baseline (a markup of 1067%). 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
Alliance/Sccho $431 121%
California Childrens Srvs $446 125%
Ccs/Monterey County $446 125%
Healthy Families $446 125%
Medi-Cal E.R. $446 125%
Medi-Cal/Eds $446 125%
Medicaid / KanCare $446 125%
Well Path $446 - $7,854 125%
Aetna $946 - $4,500 265%
Blue Cross Blue Shield $946 - $6,507 265%
Blue Shield Hmo $946 - $1,571 265%
Cigna $946 - $5,498 265%
Great-West/Phcs $946 - $5,498 265%
Health Net Pmg Hmo $946 - $4,925 265%
Pacificare Hmo $946 - $3,100 265%
Secure Horizons Dign Hmo $946 - $1,571 265%
UnitedHealthcare $946 - $3,100 265%
Medicruz $1,414 397%
Victim Compensation Plan $1,414 - $7,854 397%
Health Net Smartcare Netw $1,525 - $3,100 428%
Pacificare Ppo $1,525 - $3,100 428%
Pinnacle Claims Tpa/Bc $3,142 - $6,507 882%
Western Growers Trust/Bc $3,142 - $6,507 882%
Adventist Risk Management $3,200 - $6,283 898%
First Health $3,200 - $6,283 898%
Geha (Ccn) $3,200 - $6,283 898%
Transwestern $3,200 - $6,283 898%
Western Health Advantage $3,927 1102%
Calif Ironworkers Field $4,160 - $6,507 1167%
Carpenters H&W Trust $4,160 - $6,507 1167%
City Of Wats/Pinnacle Clm $4,160 - $6,507 1167%
Claims Management Wc $4,160 - $6,507 1167%
Delta Health Systems $4,160 - $6,507 1167%
Laborers Health & Welfare $4,160 - $6,507 1167%
Monterey Bay Pub Emp Trst $4,160 - $6,507 1167%
Operating Engineers $4,160 - $6,507 1167%
Robert Kennedy/Ccn $4,160 - $6,507 1167%
Sheet Metal Workers $4,160 - $6,507 1167%
State Compensation Fund $4,160 - $6,507 1167%
Teamsters Benefit Trust $4,160 - $6,507 1167%
Self Pay $4,713 1322%
Health Net Blue And Gold $4,925 1382%
Health Net Canopycare Hmo $4,925 1382%
Health Net Of California $4,925 1382%
Multiplan Inc Ppo $6,126 1719%
Private Healthcare System $6,126 1719%
Coastal Healthcare Admin $6,676 - $7,069 1873%
Salinas Valley Mem Hops $6,676 1873%
Aaa $7,854 2204%
Aarp $7,854 2204%
Allstate $7,854 2204%
Apwu Health Plan $7,854 2204%
Bankers Life & Casualty $7,854 2204%
Farmers Insurance $7,854 2204%
Humana $7,854 2204%
Miscellaneous Auto $7,854 2204%
Miscellaneous Insurance $7,854 2204%
North Calif Bakery Driver $7,854 2204%
Physicians Mutual $7,854 2204%
Prucare Pmg Hmo $7,854 2204%
Prucare Pmg Pos $7,854 2204%
State Farm Ins $7,854 2204%
Sutter Health Plus $7,854 2204%
Travelers Insurance $7,854 2204%
United Administrative $7,854 2204%
Wholesale Beer Distributo $7,854 2204%
Zenith National Ins $7,854 2204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 75 Nielson Street, Watsonville, CA 95076
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals