CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Citrus Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,452
Cash Discount Price: $8,172
vs. Medicare Baseline: 6.88x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Citrus Hospital is $2,452. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,172. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.88x the Medicare baseline. Located in 502 W Highland Blvd, Inverness, FL.

Cash / Self-Pay

$8,172

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,452

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: $8,172 (2293%)

Insurance Median: $2,452 (688%)

Cash: $8,172 (2293% of Medicare)

Ins. Median: $2,452 (688% 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 688% of the Medicare baseline (a markup of 588%). 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$384	108%
Access 2 Healthcare Physicians Freedom Health	$490	137%
Access 2 Healthcare Physicians Optimum	$490	137%
Freedom Health Care	$531	149%
Optimum Healthcare	$531	149%
United	$828 - $3,678	232%
Aetna	$983 - $2,452	276%
Avmed	$1,080 - $3,418	303%
Molina	$1,553 - $2,207	436%
Sunshine State Health Plan	$2,084	585%
Corvel Corporation	$3,380	948%
Rockport Healthcare Group	$3,380	948%
Prime Health	$3,451	968%
Beacon Health Options	$4,086	1146%
Plotkin Health	$4,086	1146%
Prime Health Sheriff	$4,086	1146%
Evolutions Healthcare Systems	$4,903 - $7,519	1376%
Multiplan	$6,129 - $6,947	1720%
Evernorth	$6,538	1834%

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 $8,172.
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 HCA Florida Citrus 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.