CMS Price Transparency Data

MRI, brain (no contrast)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,573
Cash Discount Price: $13,494
vs. Medicare Baseline: 10.56x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at HCA Healthone Presbyterian St Luke's is $2,573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,494. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.56x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$13,494

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,573

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%)

Cash / Self-Pay: $13,494 (5536%)

Insurance Median: $2,573 (1056%)

Cash: $13,494 (5536% of Medicare)

Ins. Median: $2,573 (1056% 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 1056% of the Medicare baseline (a markup of 956%). 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
Blue Cross Blue Shield	$167 - $9,986	69%
Pinnacol Workers Comp	$377	155%
United	$391 - $6,072	160%
Multiplan	$393 - $12,145	161%
Rocky Mountain Health Plan	$518	212%
Aetna	$1,552 - $4,048	637%
Vail Health	$2,051	841%
Cigna	$3,913 - $8,636	1605%
Bright Health	$4,048	1661%
Emerging Therapy Solutions	$6,477 - $8,636	2657%
Kaiser National Transplant	$6,477	2657%
Colorado Program For Children With Special Needs	$6,882	2823%
Western Plains Community Health	$8,771	3598%
Northcare	$9,446	3875%
Physician Health Partners	$9,446	3875%
Medical Development International	$10,795	4428%
Prime Health	$12,145	4982%

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 $13,494.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Healthone Presbyterian St Luke's is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.