CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Kootenai Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $361
Cash Discount Price: $2,075
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Kootenai Health is $361. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,075. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.01x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$2,075

Average discount available for prompt cash payment at this facility.

Insurance Median

$361

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: $2,075 (582%)

Insurance Median: $361 (101%)

Cash: $2,075 (582% of Medicare)

Ins. Median: $361 (101% 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
Coordinated Care Of Washington	$66 - $214	19%
Molina Healthcare Of Idaho	$66 - $1,023	19%
Molina Healthcare Of Washington	$66 - $214	19%
Blue Cross Blue Shield	$101 - $2,990	28%
Humana	$101 - $361	28%
Premera	$101 - $1,709	28%
Regence Blue Shield Of Idaho	$101 - $366	28%
UnitedHealthcare	$101 - $2,489	28%
Pacificsource	$102 - $2,266	29%
Aetna	$106 - $2,296	30%
Group Health/Kaiser	$150 - $1,298	42%
Magellan	$218 - $318	61%
Wellpoint	$218 - $318	61%
Mountain Health Co-Op	$2,144	602%
Cigna	$2,265 - $2,299	635%
Interwest Health	$2,351	660%
First Choice Health (Ameriben)	$2,359 - $2,395	662%

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 $2,075.
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 Kootenai Health 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.