CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Temecula Valley Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,425
Cash Discount Price: Unavailable
vs. Medicare Baseline: 9.61x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Temecula Valley Hospital is $3,425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.61x the Medicare baseline. Located in 31700 Temecula Pkwy, Temecula, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,425

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%)

Insurance Median: $3,425 (961%)

Ins. Median: $3,425 (961% 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 961% of the Medicare baseline (a markup of 861%). 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
Heritage	$221	62%
Iehp	$221	62%
Molina	$221	62%
Health_Net	$231 - $3,256	65%
United_Healthcare	$283 - $602	79%
Aetna	$335	94%
Kaiser	$414 - $3,110	116%
Cigna	$2,732 - $3,759	766%
Primecare	$3,033 - $4,174	851%
Exclusive_Care	$3,424 - $4,712	961%
Sharp_Health_Plan	$3,424 - $4,712	961%
Palomar	$3,577 - $4,921	1004%
Multiplan	$6,849 - $9,424	1922%
Blue_Shield	$11,823	3317%

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 $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Temecula Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
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.