CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Loma Linda University Children's Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,521
Cash Discount Price: $3,048
vs. Medicare Baseline: 4.27x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Loma Linda University Children's Hospital is $1,521. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,048. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.27x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$3,048

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,521

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: $3,048 (855%)

Insurance Median: $1,521 (427%)

Cash: $3,048 (855% of Medicare)

Ins. Median: $1,521 (427% 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 427% of the Medicare baseline (a markup of 327%). 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
Alpha Care Medical Group	$454 - $681	127%
Dignity Health	$454 - $681	127%
Epic Health Plan	$454 - $2,883	127%
Inland Empire Health Plan (Iehp)	$454 - $523	127%
Kaiser Foundation Hospitals	$454 - $4,807	127%
Upland Medical Group	$454	127%
Vantage Medical Group	$454 - $681	127%
Molina Healthcare Of Ca	$572 - $608	160%
Heritage Provider Network	$744	209%
Adventist Health	$1,268 - $1,441	356%
UnitedHealthcare	$1,367	384%
Lluh Dept Of Risk Management	$1,521 - $1,730	427%
Blue Shield Of California	$2,561 - $3,879	719%
Aetna	$3,443	966%
Global Benefits Group	$3,803 - $4,324	1067%
Temecula Valley Physicians Medical Group	$3,803	1067%
Trivalley Medical Group	$3,803	1067%
Blue Cross Blue Shield	$3,892	1092%
Cigna	$4,056 - $4,690	1138%
Networks By Design	$4,120 - $4,685	1156%
Multiplan	$5,070 - $5,766	1422%
Galaxy Health	$5,387 - $6,126	1511%
Prime Health Services	$5,387 - $6,126	1511%

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 $3,048.
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 Loma Linda University Children's 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.