CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Mercyone Clinton Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $829
  • Cash Discount Price: $4,358
  • vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercyone Clinton Medical Center is $829. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,358. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.33x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$4,358

Average discount available for prompt cash payment at this facility.

Insurance Median
$829

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: $4,358 (1223%)
Insurance Median: $829 (233%)
Cash: $4,358 (1223% of Medicare)
Ins. Median: $829 (233% 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 233% of the Medicare baseline (a markup of 133%). 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
Iowa Total Care $321 90%
Medicaid / KanCare $324 - $326 91%
Bcn Domestic $356 100%
Blue Benefit Administrators Of Massachusetts $356 100%
Blue Care Network $356 100%
Blue Cross Blue Shield $356 - $368 100%
Blue Distinction Transplant $356 100%
Blue Shield - Ca $356 100%
Blue Shield - Id (Regence) $356 100%
Blue Shield - Ny Highmark Northeastern $356 100%
Blue Shield - Ny Highmark Western $356 100%
Blue Shield - Pa (Highmark) $356 100%
Blue Shield - Wa (Regence) $356 100%
Kaiser Domestic $356 100%
Pre-Employment $356 100%
Wc Domestic $356 100%
Aetna $364 - $5,866 102%
Medicare (plans) $364 - $379 102%
UnitedHealthcare $371 - $6,704 104%
Amish Hospital Aid $494 139%
Oscar $507 142%
Ambetter / Centene $624 175%
Claimdoc $747 210%
Nova $747 210%
Geha $829 233%
Health Choices $1,897 532%
Medical Associates $1,897 532%
Preferred Health Choice $1,937 543%
The Alliance $4,066 1141%
1199 National Benefit Fund $5,866 1646%
Allied Benefit Systems $5,866 1646%
Asr Health Benefits $5,866 1646%
Christian Brother Services $5,866 1646%
Coventry $5,866 1646%
First Health $5,866 1646%
Lucent Health $5,866 1646%
Luminare Health $5,866 1646%
Medical Mutual $5,866 1646%
Meritain $5,866 1646%
Trustmark Small Business Benefits $5,866 1646%
Webtpa $5,866 1646%
Health Partners $5,879 1649%
Auxiant $6,034 1693%
Cigna $6,034 1693%
Medica $6,034 1693%
Midlands $6,034 1693%
Midlands Choice $6,034 1693%
Multiplan $6,034 1693%
Qualcare $6,034 1693%
Usa Managed Care $6,369 1787%
Crime Victim Assistance $6,704 1881%
Iowa Dept Of Public Health $6,704 1881%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals