CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Elkhart General Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,525
  • Cash Discount Price: $1,652
  • vs. Medicare Baseline: 4.28x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Elkhart General Hospital is $1,525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,652. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.28x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.
Cash / Self-Pay
$1,652

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,525

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: $1,652 (463%)
Insurance Median: $1,525 (428%)
Cash: $1,652 (463% of Medicare)
Ins. Median: $1,525 (428% 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 428% of the Medicare baseline (a markup of 328%). 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
Mclaren (Mi $201 56%
UnitedHealthcare $201 - $1,708 56%
Aetna $374 - $1,720 105%
Blue Cross Blue Shield $374 - $1,116 105%
Humana $374 - $1,779 105%
Pace $374 105%
Devoted Healthcare $393 - $508 110%
Plain Church $561 - $2,033 157%
Caresource $599 - $3,303 168%
Mhs $673 - $3,303 189%
Mdwise $756 - $3,303 212%
Cha $1,525 - $1,982 428%
Immergrun $1,525 - $2,033 428%
Php $1,652 - $1,779 463%
Cigna $1,830 - $1,931 513%
Multiplan $1,830 513%
Signature $1,855 520%
Encore $1,880 527%
Heartland $2,541 713%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 E Blvd, Elkhart, IN 46514
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals