CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Highland Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,847
Cash Discount Price: $3,392
vs. Medicare Baseline: 5.18x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Highland Hospital is $1,847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,392. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.18x the Medicare baseline. Located in 1411 East 31St Street, Oakland, CA.

Cash / Self-Pay

$3,392

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,847

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: $3,392 (952%)

Insurance Median: $1,847 (518%)

Cash: $3,392 (952% of Medicare)

Ins. Median: $1,847 (518% 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 518% of the Medicare baseline (a markup of 418%). 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]	$221	62%
Aetna	$496 - $4,152	139%
Blue Cross Blue Shield	$496 - $4,227	139%
Brown Toland Medical Group Alternate [1049301]	$496	139%
Brown Toland Medical Group [1049001]	$496	139%
Brown Toland Mgd Mcr Alternate [1802]	$496	139%
Medicare (plans)	$496	139%
Health Net [1022001]	$1,736	487%
Alameda Alliance Commercial Alternate [4801]	$1,847	518%
Alameda Alliance Mgd Mcal Alternate [2801]	$1,847	518%
Alameda Alliance Non-Verified [1002303]	$1,847	518%
Alameda Alliance [1002106]	$1,847	518%
Alameda Alliance [1002206]	$1,847	518%
Mc Alameda Alliance Capitation [1002103]	$1,847	518%
Cigna	$2,171	609%
UnitedHealthcare	$2,450 - $3,248	687%
Blue Shield [1006001]	$3,589 - $4,227	1007%
Kaiser Commercial [1026001]	$4,410	1237%

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 $3,392.
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 Highland Hospital 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.