CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Raulerson Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,533
  • Cash Discount Price: $13,866
  • vs. Medicare Baseline: 9.91x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Raulerson Hospital is $3,533. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,866. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.91x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
$13,866

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,533

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: $13,866 (3890%)
Insurance Median: $3,533 (991%)
Cash: $13,866 (3890% of Medicare)
Ins. Median: $3,533 (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.

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 - $6,240 232%
Avmed $1,088 - $6,933 305%
Freedom Health $1,192 334%
Optimum $1,192 334%
Aetna $1,499 - $4,160 421%
Simply Healthcare Plans $1,803 506%
Molina $2,635 - $3,744 739%
Health Sun Health Plan $2,953 828%
Corvel Corporation $3,368 945%
Careworks (Rockport) $3,438 965%
Prime Health $3,438 965%
Sunshine State Health Plan $3,536 992%
United Ppo $6,101 1712%
Plotkin Health $6,933 1945%
Prime Health Sherriff $6,933 1945%
Multiplan $10,400 - $11,786 2918%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals