CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health Sonora

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $481
  • Cash Discount Price: $731
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health Sonora is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $731. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.35x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$731

Average discount available for prompt cash payment at this facility.

Insurance Median
$481

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: $731 (205%)
Insurance Median: $481 (135%)
Cash: $731 (205% of Medicare)
Ins. Median: $481 (135% 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.

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
Blue Shield Mcare $107 - $481 30%
Central Ca Alliance Mcr Adv Profee Only $107 30%
Healthnet Mcr Adv $107 - $481 30%
Tricare $107 - $481 30%
UnitedHealthcare $107 - $7,028 30%
Ah Employee Health Plan - All Plans $118 - $865 33%
Cigna $132 - $7,765 37%
Greatwest Oa/Pos/Hmo $139 - $6,948 39%
Greatwest Ppo - All Other Plans $139 - $7,357 39%
Healthnet - All Other Plans $156 - $7,160 44%
Western Growers/Pinnacle - All Plans $159 - $4,332 45%
Blue Shield Epn $197 - $5,285 55%
Blue Shield - All Other Plans $208 - $5,459 58%
Bc Mcal $311 87%
Celtic Ca Hlth Well Mcal - All Plans $311 - $820 87%
Central Ca Alliance Mcal $311 - $673 87%
Healthnet Mcal $311 - $885 87%
Medi-Cal $311 - $594 87%
Beech Street- All Plans $383 - $6,948 107%
Trpn - Three Rivers Ppo - All Plans $383 - $6,539 107%
Central Ca Alliance Ccs Mcal $426 - $673 120%
Central Ca Alliance Chdp Mcal $426 - $673 120%
Central Ca Alliance Comm Profee Only-All Other Pla $426 120%
Aetna $481 - $4,168 135%
Phs Prime Health Srvcs-All Plans $481 135%
Bc Exchange $3,073 862%
Bc Non-Mcs - All Other Plans $3,414 958%
Kaiser - All Plans $4,087 1147%
Bc Mcs $4,097 1149%
Affordable Health - All Plans $7,357 2064%
Interplan - All Plans $7,357 2064%
Multiplan - All Plans $7,357 2064%
Phcs Ppo - All Plans $7,357 2064%
Stanilaus Foundation - All Plans $7,765 2179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals