CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Northwest Health-La Porte

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,227
  • Cash Discount Price: $2,013
  • vs. Medicare Baseline: 3.44x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Northwest Health-La Porte is $1,227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,013. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.44x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.
Cash / Self-Pay
$2,013

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,227

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: $2,013 (565%)
Insurance Median: $1,227 (344%)
Cash: $2,013 (565% of Medicare)
Ins. Median: $1,227 (344% 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 344% of the Medicare baseline (a markup of 244%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $328 - $2,355 92%
Tricare $351 98%
Aetna $364 - $3,828 102%
Blue Cross Blue Shield $364 - $1,504 102%
Humana $364 - $756 102%
Medicare (plans) $364 102%
Node Champva $369 104%
Node Hospice Non Par Agree $370 104%
Node Va $370 104%
Va Choice Program $370 104%
Node Devoted Health Mcr Adv $371 104%
Managed Health Services $382 - $756 107%
Indiana Dept Of Correction $385 108%
Node Pphp Mcr Adv $388 109%
Us Department Of Labor $462 130%
Caresource $582 - $756 163%
One Call $650 182%
Encore $666 - $4,166 187%
Prime Health In Work Comp $666 187%
In Wc $740 208%
Lutheran Network $740 - $4,073 208%
Medicaid / KanCare $756 212%
Mhs $756 212%
Encore Kba Epo $888 249%
Magnacare Ma $906 254%
Encore Kba Ppo $1,110 311%
Lutheran $1,250 351%
Self Pay $1,527 - $2,499 428%
Php $1,912 536%
Lutheran Preferred Medpartners $1,935 543%
Alpha Baking $2,083 584%
Php Freedom Network $2,785 781%
County Of Laporte $3,240 909%
Cigna $3,439 965%
Prime Health Services $3,471 974%
Prime Health Services Auto $3,471 974%
Ihn $3,703 1039%
Community Health Alliance $4,027 1130%
Sagamore Health Network $4,073 1143%
Chandler Group $4,166 1169%
Hfn Workers Compensation $4,166 1169%
Multiplan $4,166 1169%
Phcs $4,166 1169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Lincolnway, La Porte, IN 46350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals