CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lutheran Hospital of Indiana

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $996
  • Cash Discount Price: $978
  • vs. Medicare Baseline: 2.79x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lutheran Hospital of Indiana is $996. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $978. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.79x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$978

Average discount available for prompt cash payment at this facility.

Insurance Median
$996

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: $978 (274%)
Insurance Median: $996 (279%)
Cash: $978 (274% of Medicare)
Ins. Median: $996 (279% 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 279% of the Medicare baseline (a markup of 179%). 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
Ky Work Comp $90 - $836 25%
Amish Aid $107 - $996 30%
Lutheran Preferred Network $107 - $1,991 30%
Self Pay $107 - $1,195 30%
Cigna $115 - $1,205 32%
Blue Cross Blue Shield $132 - $1,517 37%
Physicians Health Plan Of Northern Indiana $141 - $1,503 40%
Aetna $143 - $1,580 40%
Lutheran Preferred $143 - $1,328 40%
Sagamore $163 - $2,386 46%
Lutheran Network $178 - $1,660 50%
Multiplan $261 - $2,755 73%
Prime Health Services $268 - $2,489 75%
Encore Health Network $293 - $2,987 82%
Advantage Health Solutions $296 - $2,755 83%
Allied Benefit Systems $321 - $2,987 90%
Evolutions $321 - $2,987 90%
UnitedHealthcare $327 - $2,021 92%
Veterans Eval Services $329 92%
Tricare $351 98%
Php Freedom Network $357 - $977 100%
Humana $363 - $756 102%
Iu Health Plan $363 102%
Managed Health Services $363 - $756 102%
Medicare (plans) $363 102%
Department Of Veterans Affairs $369 104%
Node Hospice Non Par Agree $369 104%
Node Va $369 104%
Node Devoted Health Mcr Adv $370 104%
In Dept Of Correction $384 108%
Node Pphp Mcr Adv $388 109%
Us Department Of Labor $461 129%
Lutheran Advanced Network $554 155%
Node Lutheran Network $554 - $646 155%
Node Lutheran Preferred Fixed 2 $554 155%
Align Network $591 166%
One Call Care Diagnostics $650 182%
Spreemo $650 182%
Encore Work Comp In $664 186%
Care Source $756 212%
Medicaid / KanCare $756 212%
Node Encore Kba Epo $886 249%
Node Encore Kba Ppo $1,107 311%
Encore Ppo $1,304 366%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals