CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Lukes Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $316
Cash Discount Price: $946
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Lukes Regional Medical Center is $316. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $946. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.89x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.

Cash / Self-Pay

$946

Average discount available for prompt cash payment at this facility.

Insurance Median

$316

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: $946 (265%)

Insurance Median: $316 (89%)

Cash: $946 (265% of Medicare)

Ins. Median: $316 (89% 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.

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
Nebraska Total Care	$88 - $587	25%
Aetna	$100 - $1,221	28%
Blue Cross Blue Shield	$102 - $850	29%
Molina	$102 - $355	29%
Amerivantage	$105 - $365	29%
Humana	$105 - $365	29%
UnitedHealthcare	$105 - $953	29%
Avera Health Plan	$150 - $1,467	42%
Cigna	$211 - $1,420	59%
Health Partners Open Network	$222 - $865	62%
Wellmark Uph Self-Funded	$241 - $723	68%
Amerigroup	$316	89%
Iowa Total Care	$316	89%
Medica Exchange Inspire	$1,165	327%
Medica Exchange Insure	$1,305	366%

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 $946.
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 Lukes Regional Medical Center 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.