CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Griffin Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,269
Cash Discount Price: $427
vs. Medicare Baseline: 3.56x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Griffin Hospital is $1,269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $427. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.56x the Medicare baseline. Located in 130 Division St, Derby, CT.

Cash / Self-Pay

$427

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,269

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: $427 (120%)

Insurance Median: $1,269 (356%)

Cash: $427 (120% of Medicare)

Ins. Median: $1,269 (356% 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 356% of the Medicare baseline (a markup of 256%). 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	$427 - $6,778	120%
UnitedHealthcare	$427 - $589	120%
Carepartners of Connecticut	$427	120%
Aetna	$427 - $1,938	120%
Connecticare	$427	120%
Cigna	$427 - $470	120%
Oxford	$435 - $589	122%
Connecticare (Cbi)	$1,062 - $1,269	298%
Connecticare (Cci)	$1,115 - $1,332	313%
Centivo	$5,962 - $5,970	1673%

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 $427.
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 Griffin 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.