CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Greater El Monte Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $2,765
  • Cash Discount Price: $5,532
  • vs. Medicare Baseline: 7.76x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Greater El Monte Community Hospital is $2,765. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,532. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.76x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$5,532

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,765

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: $5,532 (1552%)
Insurance Median: $2,765 (776%)
Cash: $5,532 (1552% of Medicare)
Ins. Median: $2,765 (776% 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 776% of the Medicare baseline (a markup of 676%). 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
Blue Cross Blue Shield $98 - $3,198 27%
Care 1St Medi Cal Hmo Cap Exceptional Care $200 56%
Aids Health Foundation $311 - $442 87%
Altamed Health Network $311 - $442 87%
Avanti $311 - $538 87%
Beverly Hospital $311 - $494 87%
Brand New Day $311 - $561 87%
Emanate Health $311 - $561 87%
Health Net Foundation $311 - $2,765 87%
Healthy Way La $311 87%
La Care Health Plan $311 - $3,518 87%
Other Non Contracted Medi-Cal Hmo $311 87%
State Of California $311 87%
Veterans Administration $314 88%
Central Health Plan $350 - $2,447 98%
Universal Care $400 - $1,250 112%
Associated Hispanic Physicians $404 - $1,367 113%
Apa/Aco Inc $442 124%
Blue Shield Of California $442 - $10,553 124%
Cms $442 124%
Easy Choice Health Plan $442 124%
Health Net Inc $442 - $3,954 124%
Other Non Contracted Senior Hmo $442 124%
Pacific Alliance Medical Center Reciprocal Contract $442 124%
Scan Health Plan $442 124%
UnitedHealthcare $442 - $5,490 124%
Champus Foundation $449 126%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $449 126%
Good Samaritan Medical Practice Assoc $449 - $3,838 126%
La Care Covered Direct $449 126%
Pacificare Of California $449 126%
Self-Pay $449 126%
Ahmc Healthcare Inc $451 127%
Ahmc Reciprocity Agreement $451 127%
Caloptima $457 128%
Alignment Health Plan $464 130%
Molina Healthcare $464 130%
Inter Valley Health Plan $471 132%
Molina Healthcare Of California $471 - $561 132%
San Miguel Health Plan $494 139%
Chinatown Service Center Pace $530 149%
Intercomp $537 151%
Knox-Keene Act $561 157%
Preferred Health Network $567 159%
Interplan $579 - $4,797 162%
Athens Administrators $597 167%
Multiplan $597 - $5,437 167%
Other Non Contracted Work Comp $597 167%
Cost Containment Strategies $600 168%
Employee Health Systems Medical Group $600 168%
Bella Vista Medical Group Ipa $913 - $2,878 256%
Global Care Medical Group Ipa $913 - $2,878 256%
Alta Med Health Services Med Grp $1,142 - $1,599 320%
Hollywood Presbyterian Adv Med Mcal $1,367 384%
Hollywood Presbyterian Medpoint Mcal $1,367 384%
Ahmc Reciprocity Agreement Senior/Commercial $1,370 - $1,500 384%
Cigna $1,922 539%
California Thoroughbred Horesmans Foundation $2,284 - $3,198 641%
In Custody Police Dept $2,969 - $4,157 833%
Community Care Network $3,654 - $5,117 1025%
Health Payors Organization $4,110 - $5,756 1153%
Commercial Non Contract $4,567 - $6,396 1281%
Medi-Cal Sub Acute $4,567 - $6,396 1281%
Nuclear Medicine/Whmc $4,567 - $6,396 1281%
One Legacy $4,567 - $6,396 1281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals