CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Good Samaritan Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $5,024
Cash Discount Price: $20,680
vs. Medicare Baseline: 20.61x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Good Samaritan Hospital is $5,024. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,680. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 20.61x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$20,680

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,024

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: $20,680 (8483%)

Insurance Median: $5,024 (2061%)

Cash: $20,680 (8483% of Medicare)

Ins. Median: $5,024 (2061% 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 2061% of the Medicare baseline (a markup of 1961%). 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
Santa Clara Family Health Plan	$121	50%
Physicians Medical Group	$188	77%
Blue Cross Blue Shield	$207 - $1,073	85%
United	$518 - $5,273	212%
Medcare Partners	$3,102	1273%
Blue Shield	$4,478	1837%
Aetna	$4,973 - $5,074	2040%
Nx Health Network	$12,408	5090%
Sutter Select	$12,408	5090%
Multiplan	$13,442 - $16,544	5514%
Humana	$14,476	5938%
First Health	$15,717 - $20,680	6447%
Cigna	$16,544	6787%
Healthsmart	$16,544 - $17,578	6787%
Intercontinental Corporation	$16,544	6787%
Pha Pacific Health Alliance	$16,544	6787%
Ppo Next	$16,544	6787%

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 $20,680.
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 Good Samaritan 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.