CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Marys Good Samaritan Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $980
Cash Discount Price: $2,226
vs. Medicare Baseline: 2.75x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Marys Good Samaritan Hospital is $980. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,226. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.75x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.

Cash / Self-Pay

$2,226

Average discount available for prompt cash payment at this facility.

Insurance Median

$980

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: $2,226 (625%)

Insurance Median: $980 (275%)

Cash: $2,226 (625% of Medicare)

Ins. Median: $980 (275% 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 275% of the Medicare baseline (a markup of 175%). 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
Amerigroup	$564	158%
Blue Cross Blue Shield	$662 - $2,474	186%
Aetna	$924 - $2,739	259%
Ambetter / Centene	$924	259%
Care Improvement Plus	$924	259%
Caresource	$924	259%
Cigna	$924 - $2,808	259%
Coventry	$924 - $2,568	259%
Eon Health Plan	$924	259%
Humana	$924 - $2,568	259%
Kaiser Permanente	$924	259%
Molina	$924	259%
Pruitthealth Premier	$924	259%
Todays Options Pffs	$924	259%
Todays Options Ppo	$924	259%
UnitedHealthcare	$924 - $2,632	259%
Vaccn United	$924	259%
Wellcare	$924 - $980	259%
Peach State	$980	275%
First Health	$2,568	720%
Phcs	$2,568	720%
Meritain	$2,739	768%
Multiplan	$2,910 - $2,979	816%
Nova	$2,910 - $3,082	816%
Three Rivers Provider Network	$3,082	865%

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 $2,226.
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 St Marys Good Samaritan 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.