CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health Castle

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,068
Cash Discount Price: $1,041
vs. Medicare Baseline: 5.80x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health Castle is $2,068. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,041. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.80x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$1,041

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,068

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: $1,041 (292%)

Insurance Median: $2,068 (580%)

Cash: $1,041 (292% of Medicare)

Ins. Median: $2,068 (580% 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 580% of the Medicare baseline (a markup of 480%). 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
Kfh Mcr Adv	$412	116%
Medicare (plans)	$412	116%
Ohana Health Plan - All Plans	$420	118%
Devoted Hlth Mcr Adv - All Plans	$433	121%
Alohacare Quest Mcaid - All Other Plans	$812	228%
UnitedHealthcare	$880	247%
Hmsa Hmo	$1,637	459%
Hmsa Ppo - All Other Plans	$1,637	459%
Pacific Admin Ppo - All Plans	$2,068	580%
Hwmg/Hmaa - All Plans	$2,393	671%
Mdx Hawaii Ppo - All Plans	$2,596	728%
Health Alliance - All Plans	$2,602	730%
Kfh - All Other Plans	$2,764	775%
Uni Health Alliance - All Plans	$3,034	851%
First Health Ppo - All Plans	$3,057	858%
Medicaid / KanCare	$3,252	912%
State Of Hi Nonprofit - All Plans	$5,691	1597%

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 $1,041.
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 Adventist Health Castle 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.