CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Madison County Health Care System

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $4,135
  • Cash Discount Price: $5,090
  • vs. Medicare Baseline: 11.60x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Madison County Health Care System is $4,135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,090. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.60x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$5,090

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,135

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: $5,090 (1428%)
Insurance Median: $4,135 (1160%)
Cash: $5,090 (1428% of Medicare)
Ins. Median: $4,135 (1160% 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 1160% of the Medicare baseline (a markup of 1060%). 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
Blue Cross Blue Shield $1,234 - $1,357 346%
Aetna $2,736 - $4,135 768%
Medical Associates Hp - All Plans $2,736 768%
Medigold-All Plans $2,736 768%
Tricare $2,736 768%
UnitedHealthcare $2,736 - $5,726 768%
American Hp Mcr Adv-All Plans $2,872 806%
Iowa Total Care Mcaid-All Plans $2,990 839%
Molina Mcaid/Chip -All Plans $3,095 868%
Amerigroup Mcaid-All Plans $3,170 889%
Madison County Sheriff-All Plans $3,181 892%
Oscar - All Plans $4,103 1151%
Corvel Wc-All Plans $5,726 1606%
Choicecare-All Plans $6,044 1696%
First Choice-All Plans $6,044 1696%
First Health-All Plans $6,044 1696%
Integrated Hp-All Plans $6,044 1696%
Mutual Of Omaha-All Plans $6,044 1696%
Plaines Health-All Plans $6,044 1696%
Preferred Hlth Ntwork-All Plans $6,044 1696%
Principal Healthcare-All Plans $6,044 1696%
Usa Managed Care-All Plans $6,044 1696%
Medimore Employee Hp - All Plans $6,235 1749%
Midlands Choice - All Plans $6,235 1749%
Benefit Admin Of America-All Plans $6,362 1785%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals