CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $7,543
  • Cash Discount Price: $24,331
  • vs. Medicare Baseline: 21.16x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Central Florida Lake Monroe Hospital is $7,543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24,331. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 21.16x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$24,331

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,543

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: $24,331 (6826%)
Insurance Median: $7,543 (2116%)
Cash: $24,331 (6826% of Medicare)
Ins. Median: $7,543 (2116% 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 2116% of the Medicare baseline (a markup of 2016%). 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
United $828 - $10,949 232%
Aetna $1,580 - $7,299 443%
Freedom Health $1,752 492%
Optimum $1,752 492%
Avmed $3,110 - $12,166 873%
Corvel Corporation $3,584 1006%
Prime Health $3,660 1027%
Simply $3,747 1051%
Careworks (Rockport Community) $3,773 1059%
Molina Healthcare $4,623 - $7,786 1297%
Sunshine State Health Plan $6,204 1741%
Plotkin Health $12,166 3413%
Prime Health Sheriff $12,166 3413%
Multiplan $18,248 - $20,681 5120%
Three Rivers Provider Network $18,248 5120%
Ppo Next $20,681 5802%
Novanet $21,898 6144%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals