CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Lost Rivers Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,372
Cash Discount Price: $1,700
vs. Medicare Baseline: 5.63x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Lost Rivers Medical Center is $1,372. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,700. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.63x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$1,700

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,372

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,700 (697%)

Insurance Median: $1,372 (563%)

Cash: $1,700 (697% of Medicare)

Ins. Median: $1,372 (563% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 563% of the Medicare baseline (a markup of 463%). 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
Provider Network Of America-All Plans	$439	180%
Select Health Brightpath-All Other Plans	$1,205	494%
Tricare	$1,205	494%
Ihcn Brightpath-All Other Plans	$1,272	522%
Va Pccc-All Plans	$1,299	533%
Blue Cross Blue Shield	$1,339 - $2,125	549%
Humana	$1,339 - $2,125	549%
Ihcn Brightpath Mcr Adv	$1,339	549%
Molina Mcr Adv-All Plans	$1,339	549%
Pacificsource Mcr Adv	$1,339	549%
Regence/Brightpth Slhp Mcr	$1,339	549%
Select Health Mcr Adv	$1,339	549%
Prime Hlth Mcr Adv	$1,406	577%
Aetna	$1,445 - $1,998	593%
Cigna	$1,976	811%
First Choice-All Plans	$1,976	811%
Pacificsource Navigator-All Other Plans	$2,019	828%
UnitedHealthcare	$2,019	828%
Altius Health Plan-All Plans	$2,061	845%
Regence Blue Shield-All Other Plans	$7,820	3208%

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 $1,700.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lost Rivers Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.