CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Ascension Sacred Heart Gulf

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $395
Cash Discount Price: $1,010
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Ascension Sacred Heart Gulf is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,010. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.11x the Medicare baseline. Located in 3801 E Hwy 98, Port Saint Joe, FL.

Cash / Self-Pay

$1,010

Average discount available for prompt cash payment at this facility.

Insurance Median

$395

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: $1,010 (283%)

Insurance Median: $395 (111%)

Cash: $1,010 (283% of Medicare)

Ins. Median: $395 (111% 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.

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
Blue Mcr Replacement	$384	108%
Medicare (plans)	$384	108%
Veteran	$384	108%
Wellcare	$384	108%
Healthspring Mcr Replacement	$388 - $392	109%
UnitedHealthcare	$388 - $824	109%
Aetna	$395 - $1,678	111%
Humana	$395	111%
Smarthealth	$538	151%
Oscar Health Plan	$614	172%
Ambetter / Centene	$633	178%
Occunet	$710 - $864	199%
Cigna	$1,388	389%

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 $1,010.
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 Ascension Sacred Heart Gulf 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.