CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Valley Children's Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $3,635
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 14.91x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Valley Children's Hospital is $3,635. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.91x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,635

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%)
Insurance Median: $3,635 (1491%)
Ins. Median: $3,635 (1491% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1491% of the Medicare baseline (a markup of 1391%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Allcare Ipa $731 - $2,796 300%
Kaiser $739 - $4,544 303%
Dignity Ipa_Formerly Img $1,024 420%
La Salle Ipa $1,024 420%
Sante Ipa $1,024 420%
Blue Cross Blue Shield $1,086 - $5,405 446%
Central Valley Medical Providers Ipa $1,097 - $3,495 450%
Sequoia Health Ipa $1,097 450%
Univseral Healthcare Ipa $1,097 450%
United Physicians Network Ipa $1,133 - $2,796 465%
Community Care Ipa $1,155 474%
Adventist $1,290 529%
Cencal Health $1,446 593%
Kern Family Health Care $1,461 599%
Central California Alliance For Health $1,488 610%
UnitedHealthcare $1,549 635%
Health Net $1,968 - $4,577 807%
Dignity Health Central Coast $2,771 - $3,464 1137%
Community Health $3,076 - $3,844 1262%
Stanislaus Partners In Health $3,076 - $3,844 1262%
Physicians Choice Medical Group $3,132 - $3,914 1285%
Health Plan Of San Joaquin $3,356 - $4,194 1377%
Fowler Packing $3,468 - $4,334 1423%
Dignity (Formerly Managed Care Systems) $3,524 - $4,404 1446%
Kern Legacy $3,635 - $4,544 1491%
Blue Shield $3,736 - $5,303 1533%
Aetna $3,747 - $4,683 1537%
First Health Formerly Coventry $4,139 - $5,173 1698%
Bakersfield Family Medical Group $4,195 - $5,242 1721%
Network By Design $4,335 - $5,417 1778%
Community Care Health Plan $4,473 - $5,590 1835%
Health Smart $4,474 - $5,592 1835%
Key Medical Ipa $4,474 - $5,592 1835%
Sutter Health $4,754 - $5,942 1950%
Multiplan $5,351 - $6,687 2195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens