CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Aventura Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,312
Cash Discount Price: $12,738
vs. Medicare Baseline: 9.29x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Aventura Hospital is $3,312. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,738. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.29x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.

Cash / Self-Pay

$12,738

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,312

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: $12,738 (3574%)

Insurance Median: $3,312 (929%)

Cash: $12,738 (3574% of Medicare)

Ins. Median: $3,312 (929% 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 929% of the Medicare baseline (a markup of 829%). 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
United	$828 - $5,732	232%
Avmed	$1,034 - $6,369	290%
Freedom Health	$1,095 - $2,038	307%
Optimum	$1,095	307%
Aetna	$1,116 - $3,821	313%
Simply Healthcare Plans	$1,656	465%
Molina	$2,165 - $3,439	607%
Health Sun Health Plan	$2,713	761%
Aids Healthcare	$2,802 - $15,286	786%
Mmm Of Fl (Health Advantage Plan)	$2,930	822%
United Ppo	$3,019	847%
Sunshine State Health Plan	$3,312	929%
Corvel Corporation	$3,902	1095%
Careworks (Rockport)	$3,984	1118%
Prime Health	$3,984	1118%
Plotkin Health	$6,369	1787%
Prime Health Sherriff	$6,369	1787%
Medica Healthcare	$7,388	2073%
Multiplan	$9,554 - $10,827	2680%
Evernorth Bh	$10,190	2859%

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 $12,738.
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 Aventura 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.