CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Palmetto General Hospital
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $369
- Cash Discount Price: $11,903
- vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Palmetto General Hospital is $369. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,903. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.04x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$11,903
Average discount available for prompt cash payment at this facility.
Insurance Median
$369
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: $11,903 (3340%)
Insurance Median: $369 (104%)
Cash: $11,903 (3340% of Medicare)
Ins. Median: $369 (104% 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Administration Mill Bill | $242 | 68% |
| Humana | $259 - $691 | 73% |
| Medicaid / KanCare | $259 - $11,903 | 73% |
| UnitedHealthcare | $263 - $346 | 74% |
| Avmed Broad Network | $302 | 85% |
| Aetna | $307 - $8,451 | 86% |
| Medicare (plans) | $311 - $11,903 | 87% |
| Dimension Health Wc | $323 | 91% |
| Workers Compensation | $323 | 91% |
| Healthsun Health Plans | $339 - $363 | 95% |
| Leon Health Inc | $344 | 97% |
| Devoted Health | $346 | 97% |
| Tricare | $348 | 98% |
| Bristol Hospice- Miami Dade Llc | $351 | 98% |
| Catholic Hospice | $351 | 98% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $351 | 98% |
| Employer Direct Healthcare | $351 - $410 | 98% |
| Hospice Other | $351 | 98% |
| Ima Evalutations Inc | $351 | 98% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $351 | 98% |
| Opuscare Of South Fl | $351 | 98% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $351 | 98% |
| Select Specialty Hospital | $351 | 98% |
| Veterans Administration Vaccn | $351 | 98% |
| Vitas Healthcare Hospice | $351 | 98% |
| Westchester General Hospital | $351 | 98% |
| Cigna | $363 - $5,951 | 102% |
| Longevity Health Plan | $369 | 104% |
| Imagine Health | $388 | 109% |
| Self Pay/Uninsured | $404 - $432 | 113% |
| Florida Pace Centers | $415 | 116% |
| Bright Health Management Commercial | $422 | 118% |
| Oscar Health Plan Hix | $474 | 133% |
| Naphcare Inc | $484 | 136% |
| Bc/Bs Of Fl Miami Dade Blue Select | $520 | 146% |
| Avmed Exchange | $615 | 173% |
| Ambetter / Centene | $650 | 182% |
| Bc/Bs Of Fl Health Options Hmo | $665 | 187% |
| Molina Marketplace Program Exchange | $669 | 188% |
| Bc/Bs Of Fl Network Blue | $674 | 189% |
| Bc/Bs Myblue Hmo Hix | $684 | 192% |
| Auto Insurance | $703 | 197% |
| Avmed Select Network | $719 | 202% |
| Bc/Bs Of Fl Simplyblue | $720 | 202% |
| Bc/Bs Of Fl Ppo | $727 | 204% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $742 | 208% |
| Amerihealth Caritas Next Exchange | $755 | 212% |
| Liga Contra El Cancer | $2,000 | 561% |
| Bc/Bs Of Fl Phs | $5,972 | 1676% |
| Magellan Behavioral Health | $7,142 | 2004% |
| Dimensions International | $7,737 | 2171% |
| First Health | $7,975 | 2237% |
| Dimension Health Ppo | $8,927 | 2505% |
| Beacon Health Strategies Commercial | $11,903 | 3340% |
| Commercial Non-Contracted | $11,903 | 3340% |
| Self Pay - Mcd Pending 100 Percent | $11,903 | 3340% |
| Single Case Agreement | $11,903 | 3340% |
| United Behavioral Health Psych | $11,903 | 3340% |