CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $446
Cash Discount Price: $3,508
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Shriners Hospitals for Children Northern Calif is $446. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,508. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.25x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$3,508

Average discount available for prompt cash payment at this facility.

Insurance Median

$446

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: $3,508 (984%)

Insurance Median: $446 (125%)

Cash: $3,508 (984% of Medicare)

Ins. Median: $446 (125% 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.

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
Kaiser Permanente	$100 - $446	28%
Soonercare	$269	75%
Gateway Health Plan	$339	95%
Aetna	$342 - $501	96%
Ambetter / Centene	$342 - $521	96%
Molina Healthcare Of Ms	$342	96%
Medicaid / KanCare	$368	103%
Amerigroup Nv	$373	105%
UnitedHealthcare	$382	107%
Amerihealth Caritas Nc	$393	110%
Amerihealth Caritas Sc	$393	110%
Caresource Of Oh	$393	110%
Health Plan Of Nv	$415	116%
Blue Cross Blue Shield	$446 - $926	125%
Central California Alliance For Health	$446	125%
Health Plan Of San Joaquin	$446	125%
Molina Healthcare Of Ca	$446	125%
Partnership Healthplan Of Ca	$446	125%
Northbay Healthcare	$453	127%
Sana Benefits	$479 - $634	134%
Sutter Medical Foundation	$498	140%
Providence Health Plan	$518	145%
Health Net Of Ca	$521	146%
Cigna	$553	155%
Healthchoice Of Oklahoma	$893	251%

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 $3,508.
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 Shriners Hospitals for Children Northern Calif 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.