CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: East Morgan County Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $707
Cash Discount Price: $991
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at East Morgan County Hospital is $707. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $991. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.98x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.

Cash / Self-Pay

$991

Average discount available for prompt cash payment at this facility.

Insurance Median

$707

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: $991 (278%)

Insurance Median: $707 (198%)

Cash: $991 (278% of Medicare)

Ins. Median: $707 (198% 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
Pinnacol Assurance Workers Comp	$99 - $1,187	28%
Aetna	$101 - $2,619	28%
Banner Health	$101 - $1,211	28%
Blue Cross Blue Shield	$101 - $2,121	28%
Clear Spring Health	$101 - $1,211	28%
Healthspring Life & Health Insurance Company, Inc.	$101 - $1,211	28%
Medica	$101 - $2,346	28%
Medicare (plans)	$101 - $1,211	28%
Triwest Healthcare Alliance Corp - Va Ccn	$101 - $1,211	28%
UnitedHealthcare	$101 - $2,619	28%
Longevity	$104 - $1,247	29%
Humana	$107 - $1,284	30%
Devoted Health Services	$111 - $1,332	31%
Assist Health Group	$121 - $1,453	34%
Denver Health Medical Plan	$188 - $2,253	53%
Apostrophe, Inc.	$212 - $2,534	59%
First Choice Health Network	$212 - $2,534	59%
Hue Health, Inc	$223 - $2,675	63%
Rocky Mountain Health Plans	$223 - $2,675	63%
Multiplan	$228 - $2,732	64%

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 $991.
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 East Morgan County Hospital 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.