CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health Ukiah Valley

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $594
Cash Discount Price: $743
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health Ukiah Valley is $594. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $743. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.67x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$743

Average discount available for prompt cash payment at this facility.

Insurance Median

$594

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: $743 (208%)

Insurance Median: $594 (167%)

Cash: $743 (208% of Medicare)

Ins. Median: $594 (167% 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.

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
Cigna	$60 - $5,460	17%
Blue Shield Mcr Adv	$107 - $481	30%
Kaiser Mcr Adv	$107 - $481	30%
Tricare	$107 - $481	30%
Ah Employee Health Plan - All Plans	$118 - $865	33%
UnitedHealthcare	$142 - $5,851	40%
Healthnet-All Plans	$156 - $4,004	44%
Western Growers-All Plans	$158 - $2,940	44%
Blue Shield Epn-All Other Plans	$197 - $2,667	55%
Blue Shield Non-Epn	$208 - $2,702	58%
Mendocino Lcc District-All Plans	$277 - $3,500	78%
Kaiser Medi-Cal	$311 - $594	87%
Medi-Cal	$311 - $594	87%
Aetna	$335 - $2,189	94%
Kaiser-All Other Plans	$341 - $5,600	96%
Three Rivers-All Plans	$383 - $6,300	107%
Blue Cross Blue Shield	$3,032 - $4,042	851%
Foundation For Medical Care-All Plans	$5,250	1473%
Networks By Design-All Plans	$5,600	1571%
Phcs Multiplan-All Plans	$5,600	1571%
Interplan-All Plans	$5,740	1610%
Beech Street-All Plans	$5,950	1669%
Choice Care-All Plans	$5,950	1669%
Health Mgmt Network-All Plans	$5,950	1669%

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 $743.
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 Ukiah Valley 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.