CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Highlands Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,031
  • Cash Discount Price: $6,812
  • vs. Medicare Baseline: 8.50x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Highlands Hospital is $3,031. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,812. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.50x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$6,812

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,031

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: $6,812 (1911%)
Insurance Median: $3,031 (850%)
Cash: $6,812 (1911% of Medicare)
Ins. Median: $3,031 (850% 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 850% of the Medicare baseline (a markup of 750%). 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 $586 164%
United $828 - $3,065 232%
Avmed $1,088 - $3,879 305%
Molina $1,294 363%
Aetna $1,499 - $2,044 421%
Office Of Sheiff Highland Co $2,384 669%
United Ppo $2,997 841%
Prime Health $3,353 941%

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