CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,471
Cash Discount Price: $6,261
vs. Medicare Baseline: 9.74x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Nemours Childrens Hospital, Florida is $3,471. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,261. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.74x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$6,261

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,471

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: $6,261 (1757%)

Insurance Median: $3,471 (974%)

Cash: $6,261 (1757% of Medicare)

Ins. Median: $3,471 (974% 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 974% of the Medicare baseline (a markup of 874%). 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
Tricare	$358	100%
Avmed	$900	253%
Aetna	$1,391	390%
Evolutions Healthcare	$1,802	506%
Cigna	$2,475	694%
Employers Health Network Fl	$2,504	703%
Florida Blue	$2,504 - $6,469	703%
Truli	$2,504 - $3,068	703%
UnitedHealthcare	$2,912	817%
Integra Administrative Group	$3,757	1054%
Global Medical Management	$4,070	1142%
Prime Health Services	$4,070	1142%
Star Healthcare Network	$4,070	1142%
Velocity	$4,696	1318%
First Health Network	$4,884	1370%
Pnoa	$5,009	1405%
Seminole Tribe Of Fl	$5,009	1405%
Private Healthcare Systems	$5,760	1616%

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 $6,261.
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 Nemours Childrens Hospital, Florida 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.