CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida West Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,534
Cash Discount Price: $7,900
vs. Medicare Baseline: 9.91x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida West Hospital is $3,534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,900. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.91x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.

Cash / Self-Pay

$7,900

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,534

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: $7,900 (2216%)

Insurance Median: $3,534 (991%)

Cash: $7,900 (2216% of Medicare)

Ins. Median: $3,534 (991% 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 991% of the Medicare baseline (a markup of 891%). 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 - $3,555	232%
Freedom Health	$1,003	281%
Simply	$1,217	341%
Aetna	$1,256 - $2,370	352%
Molina Healthcare	$1,501 - $2,528	421%
Sunshine State Health Plan	$2,014	565%
Avmed	$3,110 - $3,950	873%
Corvel Corporation	$3,440	965%
Prime Health	$3,512	985%
Careworks (Rockport Community)	$3,621	1016%
Plotkin Health	$3,950	1108%
Prime Health Sheriff	$3,950	1108%
Evolutions Healthcare	$5,135 - $6,715	1441%
Multiplan	$6,162 - $6,715	1729%
Evernorth	$6,320	1773%
Ppo Next	$6,715	1884%
Novanet	$7,110	1995%
Beacon Health Options	$7,900	2216%

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 $7,900.
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 West 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.