CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida South Shore Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,515
Cash Discount Price: $19,013
vs. Medicare Baseline: 9.86x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida South Shore Hospital is $3,515. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,013. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.86x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.

Cash / Self-Pay

$19,013

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,515

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: $19,013 (5334%)

Insurance Median: $3,515 (986%)

Cash: $19,013 (5334% of Medicare)

Ins. Median: $3,515 (986% 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 986% of the Medicare baseline (a markup of 886%). 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 - $8,556	232%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$894	251%
Avmed	$1,080 - $3,418	303%
Aetna	$1,186 - $5,704	333%
Access 2 Healthcare Physicians Freedom Health	$1,369	384%
Access 2 Healthcare Physicians Optimum	$1,369	384%
Freedom Health Care	$1,483	416%
Optimum Healthcare	$1,483	416%
Simply Healthcare	$2,928	821%
Molina	$3,612 - $5,134	1013%
Corvel Corporation	$3,633	1019%
Rockport Healthcare Group	$3,633	1019%
Prime Health	$3,709	1041%
Sunshine State Health Plan	$4,848	1360%
Plotkin Health	$9,507	2667%
Prime Health Sheriff	$9,507	2667%
Evolutions Healthcare Systems	$10,457 - $17,492	2934%
Multiplan	$14,260 - $16,161	4001%

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 $19,013.
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 South Shore 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.