CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Modoc Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,094
Cash Discount Price: $3,763
vs. Medicare Baseline: 8.68x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Modoc Medical Center is $3,094. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,763. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.68x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$3,763

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,094

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: $3,763 (1056%)

Insurance Median: $3,094 (868%)

Cash: $3,763 (1056% of Medicare)

Ins. Median: $3,094 (868% 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 868% of the Medicare baseline (a markup of 768%). 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
Multiplan Wc	$339	95%
Ntwrks By Design Wc - All Plans	$353	99%
Integrated Hp Wc	$356	100%
Adv Med Mgmt - All Plans	$594	167%
Medi-Cal	$594	167%
Medi-Cal 7/1/24	$594	167%
Blue Shield Comm - All Other Plans	$1,800	505%
Blue Shield Mcr Adv	$2,038	572%
Blue Shield Va	$2,038	572%
UnitedHealthcare	$2,038 - $3,575	572%
Partnership Hp - All Plans	$2,080	584%
Tricare	$2,145	602%
Healthnet Mcr Adv	$2,167	608%
Blue Cross Blue Shield	$3,094 - $3,438	868%
Blue Shield Exch	$3,094	868%
Carelon - All Plans	$3,438	965%
Corvel - All Plans	$3,538	993%
Aetna	$3,575	1003%
Coventry/First Health - All Plans	$3,575	1003%
Galaxy Health - All Plans	$3,575	1003%
Healthnet Comm - All Other Plans	$3,575	1003%
Hmn - All Plans	$3,575	1003%
Integrated Hp - All Other Plans	$3,575	1003%
Interplan - All Plans	$3,575	1003%
Multiplan - All Other Plans	$3,575	1003%
Superior Ca Ppo - All Plans	$3,575	1003%

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 $3,763.
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 Modoc Medical Center 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.