CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: West Valley Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,215
Cash Discount Price: $3,709
vs. Medicare Baseline: 6.21x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at West Valley Medical Center is $2,215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,709. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.21x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$3,709

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,215

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: $3,709 (1041%)

Insurance Median: $2,215 (621%)

Cash: $3,709 (1041% of Medicare)

Ins. Median: $2,215 (621% 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 621% of the Medicare baseline (a markup of 521%). 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
Blue Cross Blue Shield	$86 - $3,524	24%
Molina	$86 - $164	24%
Regence	$766	215%
United	$828 - $2,215	232%
Select Health Idaho (Eirmc Only)	$1,183	332%
Corizon Health	$1,372	385%
True Blue	$1,465	411%
Cigna	$2,077	583%
Pacificsource Health	$2,215	621%
Moda	$2,311	648%
St Luke'S Health Partners	$2,411	676%
Aetna	$2,934	823%
Four Rivers Hospice	$2,968	833%
Multiplan	$2,968	833%
Humana	$3,116	874%
Geha Ppo Usa	$3,153	885%
Coventry First Health	$3,338	937%
St Alphonsus Health	$3,338	937%

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 $3,709.
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 West Valley 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.