CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Florida Palms West Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,816
Cash Discount Price: $19,981
vs. Medicare Baseline: 10.71x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Florida Palms West Hospital is $3,816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,981. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.71x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.

Cash / Self-Pay

$19,981

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,816

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: $19,981 (5606%)

Insurance Median: $3,816 (1071%)

Cash: $19,981 (5606% of Medicare)

Ins. Median: $3,816 (1071% 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 1071% of the Medicare baseline (a markup of 971%). 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
Healthy Palm Beaches	$550	154%
United	$828 - $8,991	232%
Avmed	$1,088 - $9,990	305%
Aetna	$1,200 - $5,994	337%
Freedom Health	$1,718 - $3,197	482%
Optimum	$1,718	482%
Simply Healthcare Plans	$2,598	729%
Corvel Corporation	$3,757	1054%
Molina	$3,796 - $5,395	1065%
Careworks (Rockport)	$3,836	1076%
Prime Health	$3,836	1076%
Health Sun Health Plan	$4,256	1194%
Aids Healthcare	$4,396 - $23,977	1233%
Mmm Of Fl (Health Advantage Plan)	$4,596	1289%
United Ppo	$4,736	1329%
Sunshine State Health Plan	$5,195	1458%
Health Care District	$9,990	2803%
Palm Beach Juvenile Correction	$9,990	2803%
Plotkin Health	$9,990	2803%
Prime Health Sherriff	$9,990	2803%
Medica Healthcare	$11,589	3251%
Multiplan	$14,986 - $16,984	4204%

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 $19,981.
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 Palms 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.