CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: San Dimas Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $447
  • Cash Discount Price: $446
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at San Dimas Community Hospital is $447. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.25x the Medicare baseline. Located in 1350 W Covina Blvd, San Dimas, CA.
Cash / Self-Pay
$446

Average discount available for prompt cash payment at this facility.

Insurance Median
$447

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: $446 (125%)
Insurance Median: $447 (125%)
Cash: $446 (125% of Medicare)
Ins. Median: $447 (125% 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
Aids Healthcare Foundation $317 - $455 89%
Blue Shield Of Promise $317 89%
Heritage Provider Network Inc $317 - $580 89%
La Care Health Plan $317 - $446 89%
Molina Healthcare $317 - $446 89%
Traditional Medi-Cal $317 89%
Blue Cross Blue Shield $333 - $3,980 93%
Health Net Of Ca $339 - $652 95%
Rios $424 119%
Blue Shield Of Ca $446 - $890 125%
Central Health Plan $446 125%
Choice Physicians Network $446 125%
Citrus Valley Physicians Group $446 125%
Elite Health Plan $446 125%
Health Excel Inc $446 125%
Medicare (plans) $446 125%
Patient Choice Health Plan $446 125%
Primecare Medical Network $446 - $580 125%
Renal Payer Solutions $446 125%
Tricare $446 125%
UnitedHealthcare $446 - $854 125%
Brand New Day $451 - $670 127%
Imperial Health Plan Inc $473 133%
Aetna $571 160%
Ca Foundation For Medical Care $588 165%
Worker Comp $588 165%
Employer Direct Healthcare $625 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1350 W Covina Blvd, San Dimas, CA 91773
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals