CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Adventist Health Tulare

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $364
  • Cash Discount Price: $856
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Adventist Health Tulare is $364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $856. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.49x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$856

Average discount available for prompt cash payment at this facility.

Insurance Median
$364

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $856 (351%)
Insurance Median: $364 (149%)
Cash: $856 (351% of Medicare)
Ins. Median: $364 (149% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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
Cigna $39 - $2,782 16%
Blue Shield Mcare $69 - $307 28%
Fhcn Pace Mcr Adv - All Plans $69 - $307 28%
Medicare (plans) $69 - $307 28%
Tricare $69 - $307 28%
UnitedHealthcare $69 - $4,352 28%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $69 28%
Ah Employee Health Plan - All Plans $76 - $552 31%
Incentive Hlth - All Plans $76 - $552 31%
Hs Interplan-All Plans $86 - $4,025 35%
Cal Forensic Med Grp - All Plans $90 - $399 37%
Healthnet Hmo/Ppo - All Other Plans $101 - $818 41%
Blue Cross Blue Shield $113 - $1,666 46%
Blue Shield Epn $127 - $1,899 52%
Blue Shield-All Other Plans $134 - $2,626 55%
Ccipa Medi-Cal - All Plans $190 - $571 78%
Healthnet Medi-Cal $190 - $575 78%
Medi-Cal $190 - $439 78%
Upn-United Physcn Ntwrk Mcal Profee Only $190 78%
Dignity Mcr Op Only - All Other Plans $307 126%
Prime Health - All Plans $307 126%
Aetna $335 - $2,084 137%
Prison Hlthcre - All Plans $393 161%
Bright Health - All Plans $445 183%
Dignity Mcal Op Only $483 198%
Independence Op Only - All Plans $483 198%
Western Growers - All Plans $2,073 - $2,764 850%
Network By Design-All Plans $3,000 1231%
Multiplan - All Plans $3,830 - $5,107 1571%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals