CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida North Florida Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,920
Cash Discount Price: $9,824
vs. Medicare Baseline: 11.00x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida North Florida Hospital is $3,920. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,824. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.00x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$9,824

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,920

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: $9,824 (2756%)

Insurance Median: $3,920 (1100%)

Cash: $9,824 (2756% of Medicare)

Ins. Median: $3,920 (1100% 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 1100% of the Medicare baseline (a markup of 1000%). 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 - $4,421	232%
Aetna	$1,392 - $2,947	391%
Simply	$1,513	424%
Avmed	$1,568 - $4,912	440%
Molina Healthcare	$1,867 - $3,144	524%
Sunshine State Health Plan	$2,505	703%
Corvel Corporation	$3,780	1061%
Prime Health	$3,860	1083%
Careworks (Rockport Community)	$3,979	1116%
Plotkin Health	$4,912	1378%
Prime Health Sheriff	$4,912	1378%
Corizon Phs	$5,895	1654%
Multiplan	$7,663 - $8,351	2150%
Evernorth	$7,859	2205%
Evolutions Healthcare	$8,351	2343%
Ppo Next	$8,351	2343%
Novanet	$8,842	2481%
Beacon Health Options	$9,824	2756%

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 $9,824.
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 North Florida 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.