CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Englewood Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,513
Cash Discount Price: $9,309
vs. Medicare Baseline: 7.05x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Englewood Hospital is $2,513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,309. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.05x the Medicare baseline. Located in 700 Medical Blvd, Englewood, FL.

Cash / Self-Pay

$9,309

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,513

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: $9,309 (2612%)

Insurance Median: $2,513 (705%)

Cash: $9,309 (2612% of Medicare)

Ins. Median: $2,513 (705% 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 705% of the Medicare baseline (a markup of 605%). 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$438	123%
Access 2 Healthcare Physicians Freedom Health	$670	188%
Access 2 Healthcare Physicians Optimum	$670	188%
Freedom Health Care	$726	204%
Optimum Healthcare	$726	204%
United	$828 - $4,189	232%
Avmed	$1,080 - $3,418	303%
Aetna	$1,101 - $2,793	309%
Simply Healthcare	$1,434	402%
Molina	$1,769 - $2,513	496%
Sunshine State Health Plan	$2,374	666%
Behealthy America	$3,630	1018%
Corvel Corporation	$3,633	1019%
Rockport Healthcare Group	$3,633	1019%
Prime Health	$3,709	1041%
Evolutions Healthcare Systems	$4,654 - $8,564	1306%
Plotkin Health	$4,654	1306%
Prime Health Sheriff	$4,654	1306%
Multiplan	$6,982 - $7,912	1959%

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 $9,309.
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 Englewood 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.