CMS Price Transparency Data

MRI, brain (no contrast)

Facility: HCA Florida Highlands Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $2,175
  • Cash Discount Price: $4,887
  • vs. Medicare Baseline: 8.92x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at HCA Florida Highlands Hospital is $2,175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,887. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.92x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$4,887

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,175

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $4,887 (2005%)
Insurance Median: $2,175 (892%)
Cash: $4,887 (2005% of Medicare)
Ins. Median: $2,175 (892% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 892% of the Medicare baseline (a markup of 792%). 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
Freedom Health $420 172%
United $518 - $2,199 212%
Molina $929 381%
Avmed $1,088 - $3,879 446%
Aetna $1,466 - $2,012 601%
Office Of Sheiff Highland Co $1,710 701%
United Ppo $2,150 882%
Prime Health $2,296 942%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals