CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Kapiolani Medical Center for Women & Children

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,026
Cash Discount Price: $2,143
vs. Medicare Baseline: 2.88x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Kapiolani Medical Center for Women & Children is $1,026. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,143. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.88x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$2,143

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,026

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: $2,143 (601%)

Insurance Median: $1,026 (288%)

Cash: $2,143 (601% of Medicare)

Ins. Median: $1,026 (288% 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 288% of the Medicare baseline (a markup of 188%). 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
Mdx	$346 - $357	97%
Alohacare	$357 - $393	100%
Hmsa	$357 - $1,637	100%
Kaiser	$357 - $3,142	100%
Devoted	$375	105%
Ohana	$429 - $1,043	120%
Hwmg/Hmaa	$642	180%
Uha	$1,023 - $1,786	287%
Pac Admin	$1,026	288%
UnitedHealthcare	$1,320	370%
Mimoh	$2,500 - $2,678	701%
Hcha	$2,857	802%
Multiplan	$2,857 - $3,035	802%
Verdegard	$2,857	802%
Mccp	$3,035	851%
Coventry	$3,214	902%

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 $2,143.
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 Kapiolani Medical Center for Women & Children 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.