CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Jeff Davis Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $4,816
  • Cash Discount Price: $2,406
  • vs. Medicare Baseline: 13.51x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Jeff Davis Hospital is $4,816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,406. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 13.51x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.
Cash / Self-Pay
$2,406

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,816

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: $2,406 (675%)
Insurance Median: $4,816 (1351%)
Cash: $2,406 (675% of Medicare)
Ins. Median: $4,816 (1351% 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 1351% of the Medicare baseline (a markup of 1251%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Pen_Network $461 129%
Medicaid / KanCare $1,105 - $4,331 310%
Humana $1,127 - $6,868 316%
Peach_State $1,127 - $1,607 316%
Wellcare $1,127 - $1,607 316%
Medicare (plans) $1,756 - $2,530 493%
Blue Cross Blue Shield $1,792 - $6,060 503%
Care_Improvement_Plus $1,792 - $2,555 503%
Coventry_Hmo $3,966 - $5,656 1113%
Coventry_Pos $3,966 - $5,656 1113%
Uhc_Hmo $4,250 - $6,060 1192%
Uhc_Indemnity $4,250 - $6,060 1192%
Uhc_Ppo $4,250 - $6,060 1192%
Coventry_Ppo $4,363 - $6,222 1224%
Beech_Street $4,533 - $6,464 1272%
Care_Source $4,533 - $6,464 1272%
Cigna $4,533 - $6,464 1272%
One_Health_Ppo $4,533 - $6,464 1272%
Choicecare $4,816 - $6,868 1351%
Community_Care_Network $4,816 - $6,868 1351%
Georgia_Hospital_Network $4,816 - $6,868 1351%
Industry_Buying_Group $4,816 - $6,868 1351%
Novanet $4,816 - $6,868 1351%
Principal_Health_Care_Of_Georgia $4,816 - $6,868 1351%
Three_Rivers_Provider_Network $4,816 - $6,868 1351%
Usa_Managed_Care $4,816 - $6,868 1351%
Memorial_Health_Partners $5,099 - $7,272 1431%
Tricare $5,269 - $7,515 1478%
Multiplan $5,383 - $7,676 1510%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 163 South Tallahassee Street, Hazlehurst, GA 31539
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals