CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Fort Walton-Destin Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $7,759
Cash Discount Price: $20,154
vs. Medicare Baseline: 21.77x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Fort Walton-Destin Hospital is $7,759. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,154. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 21.77x the Medicare baseline. Located in 1000 Mar-Walt Dr, Fort Walton Beach, FL.

Cash / Self-Pay

$20,154

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,759

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: $20,154 (5654%)

Insurance Median: $7,759 (2177%)

Cash: $20,154 (5654% of Medicare)

Ins. Median: $7,759 (2177% 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 2177% of the Medicare baseline (a markup of 2077%). 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 - $9,069	232%
Simply	$3,104	871%
Avmed	$3,110 - $10,077	873%
Aetna	$3,399 - $6,046	954%
Corvel Corporation	$3,617	1015%
Prime Health	$3,694	1036%
Careworks (Rockport Community)	$3,808	1068%
Molina Healthcare	$3,829 - $6,449	1074%
Sunshine State Health Plan	$5,139	1442%
Plotkin Health	$10,077	2827%
Prime Health Sheriff	$10,077	2827%
Evolutions Healthcare	$13,100 - $18,139	3675%
Naphcare	$13,100	3675%
Multiplan	$15,720 - $17,131	4410%
Evernorth	$16,123	4523%
Ppo Next	$17,131	4806%
Novanet	$18,139	5089%
Beacon Health Options	$20,154	5654%

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 $20,154.
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 Fort Walton-Destin 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.