CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health Tulare

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $449
  • Cash Discount Price: $894
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health Tulare is $449. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $894. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.26x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$894

Average discount available for prompt cash payment at this facility.

Insurance Median
$449

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: $894 (251%)
Insurance Median: $449 (126%)
Cash: $894 (251% of Medicare)
Ins. Median: $449 (126% 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.

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 $60 - $4,161 17%
Blue Shield Mcare $107 - $449 30%
Fhcn Pace Mcr Adv - All Plans $107 - $449 30%
Medicare (plans) $107 - $449 30%
Tricare $107 - $449 30%
UnitedHealthcare $107 - $6,510 30%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $107 30%
Ah Employee Health Plan - All Plans $118 - $808 33%
Incentive Hlth - All Plans $118 - $808 33%
Hs Interplan-All Plans $134 - $6,022 38%
Cal Forensic Med Grp - All Plans $139 - $583 39%
Healthnet Hmo/Ppo - All Other Plans $156 - $1,196 44%
Blue Cross Blue Shield $179 - $3,280 50%
Blue Shield Epn $197 - $2,125 55%
Blue Shield-All Other Plans $208 - $2,949 58%
Ccipa Medi-Cal - All Plans $311 - $773 87%
Healthnet Medi-Cal $311 - $779 87%
Medi-Cal $311 - $594 87%
Upn-United Physcn Ntwrk Mcal Profee Only $311 87%
Aetna $335 - $2,084 94%
Dignity Mcr Op Only - All Other Plans $449 126%
Prime Health - All Plans $449 126%
Prison Hlthcre - All Plans $574 161%
Bright Health - All Plans $651 183%
Dignity Mcal Op Only $654 183%
Independence Op Only - All Plans $654 183%
Network By Design-All Plans $3,000 842%
Western Growers - All Plans $4,134 1160%
Multiplan - All Plans $7,640 2143%

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