CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Twin Cities Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,270
Cash Discount Price: $5,030
vs. Medicare Baseline: 9.17x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Twin Cities Hospital is $3,270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,030. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.17x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.

Cash / Self-Pay

$5,030

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,270

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: $5,030 (1411%)

Insurance Median: $3,270 (917%)

Cash: $5,030 (1411% of Medicare)

Ins. Median: $3,270 (917% 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 917% of the Medicare baseline (a markup of 817%). 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
Simply	$775	217%
United	$828 - $2,264	232%
Molina Healthcare	$956 - $1,610	268%
Sunshine State Health Plan	$1,283	360%
Aetna	$1,509 - $5,100	423%
Avmed	$2,515 - $3,418	706%
Plotkin Health	$2,515	706%
Prime Health Sheriff	$2,515	706%
Evolutions Healthcare	$3,270 - $4,276	917%
Corvel Corporation	$3,617	1015%
Prime Health	$3,694	1036%
Careworks (Rockport Community)	$3,808	1068%
Multiplan	$3,923 - $4,276	1101%
Ppo Next	$4,276	1200%
Novanet	$4,527	1270%

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 $5,030.
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 Twin Cities 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.