CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Mayers Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,208
Cash Discount Price: $1,065
vs. Medicare Baseline: 3.39x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mayers Memorial Hospital is $1,208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,065. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.39x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$1,065

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,208

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: $1,065 (299%)

Insurance Median: $1,208 (339%)

Cash: $1,065 (299% of Medicare)

Ins. Median: $1,208 (339% 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 339% of the Medicare baseline (a markup of 239%). 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
Blue Shield Ca Va	$102 - $1,136	29%
Blue Shield Mcr Adv	$102 - $1,136	29%
Tricare	$102 - $1,196	29%
Health Net Mcr Adv	$107 - $1,196	30%
Arcadian Health Services-All Plans	$112 - $1,196	31%
Imperial Health Plan-All Plans	$121 - $1,351	34%
Cigna	$303 - $1,721	85%
Corvel Ppo-All Plans	$303 - $1,721	85%
Coventry/First Health-All Plans	$303 - $1,721	85%
Integrated Hp-All Plans	$303 - $1,721	85%
Interplan-All Plans	$303 - $1,721	85%
Medi-Cal	$311 - $594	87%
Blue Cross Blue Shield	$1,208 - $1,549	339%
Health Net Prison	$1,303	366%
Blue Shield Ca Exchange	$1,549	435%
Blue Shield-All Other Plans	$1,721	483%
Hmn-All Plans	$1,721	483%
Multiplan Phcs-All Plans	$1,721	483%
Pfmc-All Plans	$1,721	483%
Superior Ca-All Plans	$1,721	483%
Health Net-All Other Plans	$1,802	506%
Pacificare-All Plans	$1,812	508%
Partnership Hp-All Plans	$1,812	508%

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 $1,065.
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 Mayers Memorial 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.