CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lost Rivers Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,034
Cash Discount Price: $2,520
vs. Medicare Baseline: 5.71x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lost Rivers Medical Center is $2,034. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,520. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.71x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$2,520

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,034

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: $2,520 (707%)

Insurance Median: $2,034 (571%)

Cash: $2,520 (707% of Medicare)

Ins. Median: $2,034 (571% 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 571% of the Medicare baseline (a markup of 471%). 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	$642	180%
Select Health Brightpath-All Other Plans	$1,786	501%
Tricare	$1,786	501%
Ihcn Brightpath-All Other Plans	$1,885	529%
Va Pccc-All Plans	$1,925	540%
Blue Cross Blue Shield	$1,984 - $3,150	557%
Humana	$1,984 - $3,150	557%
Ihcn Brightpath Mcr Adv	$1,984	557%
Molina Mcr Adv-All Plans	$1,984	557%
Pacificsource Mcr Adv	$1,984	557%
Regence/Brightpth Slhp Mcr	$1,984	557%
Select Health Mcr Adv	$1,984	557%
Prime Hlth Mcr Adv	$2,084	585%
Aetna	$2,142 - $2,961	601%
Cigna	$2,930	822%
First Choice-All Plans	$2,930	822%
Pacificsource Navigator-All Other Plans	$2,992	839%
UnitedHealthcare	$2,992	839%
Altius Health Plan-All Plans	$3,056	857%
Regence Blue Shield-All Other Plans	$11,592	3252%

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 $2,520.
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 Lost Rivers 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.