CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Saint Mary's Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,240
  • Cash Discount Price: $2,689
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Saint Mary's Hospital is $1,240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,689. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.48x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$2,689

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,240

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: $2,689 (754%)
Insurance Median: $1,240 (348%)
Cash: $2,689 (754% of Medicare)
Ins. Median: $1,240 (348% 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 348% of the Medicare baseline (a markup of 248%). 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
Connecticut Dept of Correction $386 108%
Aetna $410 - $589 115%
Blue Cross Blue Shield $410 - $1,240 115%
Medicare (plans) $410 - $427 115%
UnitedHealthcare $410 - $4,889 115%
Cca Senior Care Options $418 117%
Cigna $422 - $3,911 118%
Allegiance $487 137%
Health Partners $487 137%
Magnacare $487 137%
1199 National Benefit Fund $589 165%
Allied Benefit Systems $589 165%
Gravie Admin Services $589 165%
Hap $589 165%
Luminare Health $589 165%
Meritain $589 165%
Nippon Life Ins $589 165%
Webtpa $589 165%
Geha $611 171%
Harvard Pilgrim Healthcare $611 171%
Centivo $836 235%
Claimdoc $878 246%
Diversified Administrators $878 246%
Innovative Health Plan II $878 246%
Bcn Domestic $1,240 348%
Blue Benefit Administrators of Massachusetts $1,240 348%
Blue Care Network $1,240 348%
Blue Distinction Transplant $1,240 348%
Blue Shield - Ca $1,240 348%
Blue Shield - Id (Regence) $1,240 348%
Blue Shield - Ny Highmark Northeastern $1,240 348%
Blue Shield - Ny Highmark Western $1,240 348%
Blue Shield - PA (Highmark) $1,240 348%
Blue Shield - Wa (Regence) $1,240 348%
Health Choices $1,240 348%
Kaiser Domestic $1,240 348%
Pre-Employment $1,240 348%
Unicare $1,240 348%
Wc Domestic $1,240 348%
Wellpoint $1,240 348%
Connecticare $1,348 - $1,375 378%
Carelon Behavioral Health $2,444 686%
Health New England $2,593 727%
Allied National Global Care $3,765 1056%
Asrm - Reliance Standard Life Insurance $3,765 1056%
Christian Care Ministry $3,765 1056%
Dean Health $3,765 1056%
Fallon Health $3,765 1056%
Family Life Insurance Company $3,765 1056%
Ghc Scw $3,765 1056%
International Benefit Administrators $3,765 1056%
Lifetime Benefit Solutions $3,765 1056%
Manhattan Life $3,765 1056%
Medi Share $3,765 1056%
Multiplan $3,765 1056%
Mvp $3,765 1056%
PHCS $3,765 1056%
Pai $3,765 1056%
Pan-American Life $3,765 1056%
Paramount HMO $3,765 1056%
Trinity Health Share $3,765 1056%
Prime Health Services $3,911 1097%
Health Smart $4,156 1166%
United Behavioral Health Eap $4,889 1372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals