CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Medstar Georgetown University Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $868
Cash Discount Price: $3,578
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Medstar Georgetown University Hospital is $868. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,578. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.44x the Medicare baseline. Located in 3800 Reservoir Rd, Washington, DC.

Cash / Self-Pay

$3,578

Average discount available for prompt cash payment at this facility.

Insurance Median

$868

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: $3,578 (1004%)

Insurance Median: $868 (244%)

Cash: $3,578 (1004% of Medicare)

Ins. Median: $868 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
Carefirst Advantage Inc	$206 - $412	58%
Tricare	$206 - $412	58%
UnitedHealthcare	$206 - $1,927	58%
Aetna	$212 - $2,240	59%
Health Care Service Corporation	$216 - $433	61%
Humana	$216 - $433	61%
Blue Cross Blue Shield	$321 - $641	90%
Amerigroup	$436 - $871	122%
Amerihealth Caritas District Of Columbia	$436 - $871	122%
Hscsn	$436 - $871	122%
Medstar Family Choice Inc	$436 - $1,541	122%
Cigna	$2,517	706%
Carefirst Blue Choice Inc	$3,388	951%
Pfc	$3,578	1004%
Private Healthcare Systems (Phcs)	$4,404	1236%
First Health	$4,679	1313%
Beech Street	$4,954	1390%

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 $3,578.
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 Medstar Georgetown University 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.