CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,932
Cash Discount Price: $21,904
vs. Medicare Baseline: 11.03x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Healthone Presbyterian St Luke's is $3,932. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,904. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.03x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$21,904

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,932

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: $21,904 (6145%)

Insurance Median: $3,932 (1103%)

Cash: $21,904 (6145% of Medicare)

Ins. Median: $3,932 (1103% 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 1103% of the Medicare baseline (a markup of 1003%). 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	$260 - $16,209	73%
Pinnacol Workers Comp	$592	166%
Multiplan	$617 - $19,713	173%
United	$626 - $9,857	176%
Rocky Mountain Health Plan	$828	232%
Aetna	$1,552 - $6,571	435%
Vail Health	$3,329	934%
Cigna	$6,352 - $14,018	1782%
Bright Health	$6,571	1844%
Emerging Therapy Solutions	$10,514 - $14,018	2950%
Kaiser National Transplant	$10,514	2950%
Colorado Program For Children With Special Needs	$11,171	3134%
Western Plains Community Health	$14,237	3994%
Northcare	$15,333	4302%
Physician Health Partners	$15,333	4302%
Medical Development International	$17,523	4916%
Prime Health	$19,713	5531%

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 $21,904.
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 HCA Healthone Presbyterian St Luke's 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.