CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Bayhealth Hospital, Sussex Campus

Billing Code: 70553 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$699

about 2.0× the $356 Medicare rate · typically $461–$1,218

modeled estimate · not a bill or quote

What this hospital charges insurers

$475

Below the fair price — a good deal

about $224 under the fair price · 1.3× Medicare

Medicare pays $356 Fair price $699 This hospital $475 Cash price $4,417 Hospital's list price $5,258

How we calculate the fair BaseRate →

How this hospital compares to other DE hospitals

A typical price — 4 charge more and 3 charge less, among the 8 DE hospitals compared.

Cheapest $314 Priciest $1,675

Black dot = this hospital, among the 8 DE hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, brain (with and without contrast) is about $699 (about 2.0× the $356 Medicare rate). Bayhealth Hospital, Sussex Campus charges insurers about $475, or about $4,417 in cash — below the fair price — a good deal. Located in Milford, DE.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$1,570 - $1,763	440%
Aetnamajor	$377	106%
Ambetter (Centene)	$566	159%
AmeriHealth	$351 - $385	98%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,417), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 70553.

Insurance Before you use insurance

Call your insurance company to confirm Bayhealth Hospital, Sussex Campus is in-network.
Ask your insurer whether prior approval is required for CPT code 70553.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Bayhealth Hospital, Sussex Campus

Compare: MRI, brain (with and without contrast) at other DE hospitals

Insurance negotiated median for the same procedure, sorted lowest first.