CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Valley Children's Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $5,465
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 15.33x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Valley Children's Hospital is $5,465. 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 $356.43, this hospital’s rate is 15.33x 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
$5,465

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%)
Insurance Median: $5,465 (1533%)
Ins. Median: $5,465 (1533% 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 1533% of the Medicare baseline (a markup of 1433%). 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.

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
Allcare Ipa $1,367 384%
Kaiser $1,382 - $7,136 388%
UnitedHealthcare $1,549 435%
Blue Cross Blue Shield $1,801 - $5,405 505%
Dignity Ipa_Formerly Img $1,914 537%
La Salle Ipa $1,914 537%
Sante Ipa $1,914 537%
Central Valley Medical Providers Ipa $2,050 - $5,490 575%
Sequoia Health Ipa $2,050 575%
Univseral Healthcare Ipa $2,050 575%
United Physicians Network Ipa $2,119 595%
Community Care Ipa $2,160 606%
Adventist $2,411 676%
Cencal Health $2,703 758%
Kern Family Health Care $2,732 766%
Central California Alliance For Health $2,781 780%
Health Net $3,864 - $7,189 1084%
Dignity Health Central Coast $5,440 1526%
Community Health $6,038 1694%
Stanislaus Partners In Health $6,038 1694%
Physicians Choice Medical Group $6,148 1725%
Dignity (Formerly Managed Care Systems) $6,535 1833%
Health Plan Of San Joaquin $6,587 1848%
Fowler Packing $6,807 1910%
Kern Legacy $7,136 2002%
Blue Shield $7,333 - $8,330 2057%
Aetna $7,356 2064%
First Health Formerly Coventry $7,560 2121%
Bakersfield Family Medical Group $8,234 2310%
Network By Design $8,509 2387%
Community Care Health Plan $8,780 2463%
Health Smart $8,783 2464%
Key Medical Ipa $8,783 2464%
Sutter Health $9,332 2618%
Multiplan $10,504 2947%

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