CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Highland Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $988
Cash Discount Price: $2,629
vs. Medicare Baseline: 4.05x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Highland Hospital is $988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,629. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.05x the Medicare baseline. Located in 1411 East 31St Street, Oakland, CA.

Cash / Self-Pay

$2,629

Average discount available for prompt cash payment at this facility.

Insurance Median

$988

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $2,629 (1078%)

Insurance Median: $988 (405%)

Cash: $2,629 (1078% of Medicare)

Ins. Median: $988 (405% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 405% of the Medicare baseline (a markup of 305%). 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
Kaiser Medi-Cal Managed Care [1026106]	$131	54%
Aetna	$339 - $3,218	139%
Blue Cross Blue Shield	$339 - $3,276	139%
Brown Toland Medical Group Alternate [1049301]	$339	139%
Brown Toland Medical Group [1049001]	$339	139%
Brown Toland Mgd Mcr Alternate [1802]	$339	139%
Medicare (plans)	$339	139%
Alameda Alliance Commercial Alternate [4801]	$988	405%
Alameda Alliance Mgd Mcal Alternate [2801]	$988	405%
Alameda Alliance Non-Verified [1002303]	$988	405%
Alameda Alliance [1002106]	$988	405%
Alameda Alliance [1002206]	$988	405%
Mc Alameda Alliance Capitation [1002103]	$988	405%
Health Net [1022001]	$1,187	487%
Cigna	$1,383	567%
UnitedHealthcare	$1,899 - $2,517	779%
Blue Shield [1006001]	$2,782 - $3,276	1141%
Kaiser Commercial [1026001]	$3,418	1402%

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 $2,629.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Highland Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.