CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Winnmed

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $823
Cash Discount Price: $2,254
vs. Medicare Baseline: 2.31x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Winnmed is $823. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,254. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.31x the Medicare baseline. Located in 901 Montgomery Street, Decorah, IA.

Cash / Self-Pay

$2,254

Average discount available for prompt cash payment at this facility.

Insurance Median

$823

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: $2,254 (632%)

Insurance Median: $823 (231%)

Cash: $2,254 (632% of Medicare)

Ins. Median: $823 (231% 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 231% of the Medicare baseline (a markup of 131%). 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
Health Partners - All Plans	$106 - $4,284	30%
Medica Ifb	$136 - $4,303	38%
Medica Mayo Clinic	$136 - $4,284	38%
Medica Mayo Health Plan - All Other Plans	$136 - $4,443	38%
UnitedHealthcare	$168 - $2,727	47%
Blue Cross Blue Shield	$203 - $1,357	57%
Preferred One - All Plans	$1,675 - $4,443	470%
Aetna	$4,209 - $4,537	1181%

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 $2,254.
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 Winnmed 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.