CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health Howard Memorial

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,967
Cash Discount Price: $1,539
vs. Medicare Baseline: 5.52x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health Howard Memorial is $1,967. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,539. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.52x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$1,539

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,967

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: $1,539 (432%)

Insurance Median: $1,967 (552%)

Cash: $1,539 (432% of Medicare)

Ins. Median: $1,967 (552% 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 552% of the Medicare baseline (a markup of 452%). 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
Cigna	$60 - $8,361	17%
Blue Shield Mcare	$107 - $1,967	30%
Medicare (plans)	$107 - $1,987	30%
Tricare	$107 - $1,967	30%
UnitedHealthcare	$107 - $7,612	30%
Ah Employee Health Plan - All Plans	$118 - $5,115	33%
Healthnet - All Plans	$156 - $8,066	44%
Western Growers/Pinnacle - All Plans	$164 - $7,378	46%
Blue Shield - All Other Plans	$208 - $4,776	58%
Medi-Cal	$311 - $594	87%
Aetna	$335 - $6,600	94%
Brms - All Plans	$362 - $8,361	102%
Blue Cross Blue Shield	$3,266 - $3,919	916%
Blue Shield Epn	$4,605	1292%
First Health Ppo - All Plans	$7,870	2208%
Ghn Ppo - All Plans	$7,870	2208%

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 $1,539.
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 Adventist Health Howard Memorial 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.