CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Menifee Global Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,422
  • Cash Discount Price: $4,863
  • vs. Medicare Baseline: 3.99x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Menifee Global Medical Center is $1,422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,863. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.99x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$4,863

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,422

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: $4,863 (1364%)
Insurance Median: $1,422 (399%)
Cash: $4,863 (1364% of Medicare)
Ins. Median: $1,422 (399% 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 399% of the Medicare baseline (a markup of 299%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Tricare $289 - $417 81%
Lasalle Medical Assoc (Ancillary) Mcal Hmo $367 103%
Aetna $447 - $2,952 125%
Altamed Comm Hmo (Ancillary) $447 - $5,403 125%
Altamed Health Services Senior $447 125%
Altamed Sr/Pace $447 125%
Blue Shield Senior $447 125%
Central Health Plan Senior $447 125%
Clever Care Health Plan Sr $447 125%
For Your Benefit Senior $447 125%
Guidant Health Plan Senior $447 125%
Health Net Senior $447 125%
Hpn Senior $447 125%
Humana $447 125%
Ic $447 - $5,403 125%
Kaiser Senior $447 125%
Lasalle Medical Assoc (Ancillary) Senior $447 125%
Managed Health Network Sr $447 125%
Medicare (plans) $447 125%
Neighborhood Healthcare Pace $447 125%
Primecare Senior $447 125%
Prospect Health Plan Sr Hmo $447 125%
Scan Senior $447 125%
Sr Capitation $447 125%
UnitedHealthcare $447 - $589 125%
Veterans Administration $447 125%
Imperial Health Plan Of Ca $449 126%
Lasalle Medical Assoc (Ancillary) Commercial $449 126%
Point Comfort Underwriters $449 126%
Self Pay/Ab774/Charity Discount $449 126%
Cigna $466 - $4,322 131%
Health Net Enhanced Ppo $476 - $625 134%
Align Senior Care $500 140%
Welbehealth Sr/Pace $500 140%
Prime Health Services Senior $513 144%
Molina Covered Ca $536 150%
Coventry $537 - $558 151%
Prime Health Services Wcomp $537 151%
Iehp Covered Ca $558 157%
Three Rivers Wcomp $585 164%
Workers Comp Non-Contracted $597 167%
Prospect Health Plan Comm Hmo $603 169%
Hpn Commercial/Covered Ca $625 175%
Health Net Comm $670 188%
Three Rivers Network $785 220%
Velocity $785 - $2,431 220%
Primecare Commercial $845 237%
Blue Shield Epn $1,255 352%
Health Net Medi-Cal $1,367 384%
Hpn Mcal $1,367 384%
Kaiser Medi-Cal $1,367 384%
Prospect Health Plan Mcal Hmo $1,408 395%
Blue Cross Blue Shield $1,435 403%
Blue Shield Commercial $1,478 415%
Molina Medi-Cal $1,613 453%
Altamed Mcal Hmo $1,914 537%
Altamed Mcal/Pace $1,914 537%
Choice Physicians Network $1,914 537%
Iehp Medi-Cal $2,050 575%
First Health Commercial $2,270 - $2,837 637%
Multiplan Ppo $3,026 - $3,782 849%
Multiplan Wcomp $3,026 - $3,782 849%
Pnoa-Provider Network Of America $3,458 - $4,322 970%
Prime Health Services Commercial $3,458 - $4,322 970%
Ava Hospice $4,323 - $5,403 1213%
Kaiser Commercial $4,323 - $5,403 1213%
Living Waters Hospice $4,323 - $5,403 1213%
Managed Health Network $4,323 - $5,403 1213%
Other Insurance Loa $4,323 - $5,403 1213%
Pacific Valley Hospice $4,323 - $5,403 1213%
Private Pay $4,323 - $5,403 1213%
Silverado Hospice $4,323 - $5,403 1213%
Vna Hospice $4,323 - $5,403 1213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 28400 McCall Boulevard, Sun City, CA 92585
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals