CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Fairview Park Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $917
Cash Discount Price: $13,388
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Fairview Park Hospital is $917. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,388. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.57x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

$13,388

Average discount available for prompt cash payment at this facility.

Insurance Median

$917

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: $13,388 (3756%)

Insurance Median: $917 (257%)

Cash: $13,388 (3756% of Medicare)

Ins. Median: $917 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Blue Cross Blue Shield	$142 - $538	40%
Health One Alliance	$369	104%
Ambetter / Centene	$421	118%
Aetna	$461 - $7,381	129%
Core Resources	$509	143%
United	$828 - $6,025	232%
Prime Health	$898	252%
Employer'S Health Network	$917	257%
Rockport United Network	$917	257%
Identity Mco	$936	263%
Synergy Health Network	$936	263%
Amerigroup	$1,794	503%
Nhc Advantage	$2,544	714%
Pruitt Health	$2,544	714%
Peach State	$2,678	751%
Wellcare	$2,678	751%
Memorial Health Plan	$2,945	826%
Americas 1St Choice	$3,749	1052%
Leavitt Risk Partners	$4,016	1127%
Dodge County Hospital	$6,694	1878%
American Steel Products	$11,380	3193%
City Of Eastman	$11,380	3193%
Dodge Co Board Of Commissioners	$11,380	3193%
Graham Brothers Construction	$11,380	3193%
Multiplan	$12,049	3380%
Novanet	$12,049	3380%

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 $13,388.
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 Fairview Park 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.