CMS Price Transparency Data

MRI, brain (no contrast)

Facility: St Joseph Health System, LLC

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $830
  • Cash Discount Price: $1,109
  • vs. Medicare Baseline: 3.40x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at St Joseph Health System, LLC is $830. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,109. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.40x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$1,109

Average discount available for prompt cash payment at this facility.

Insurance Median
$830

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: $1,109 (455%)
Insurance Median: $830 (340%)
Cash: $1,109 (455% of Medicare)
Ins. Median: $830 (340% 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 340% of the Medicare baseline (a markup of 240%). 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
Veterans Eval Services $222 91%
UnitedHealthcare $224 - $2,021 92%
Tricare $240 98%
Aetna $248 - $1,909 102%
Blue Cross Blue Shield $248 - $1,037 102%
Humana $248 - $464 102%
Managed Health Services $248 - $505 102%
Medicare (plans) $248 102%
Department Of Veterans Affairs $252 103%
Node Hospice Non Par Agree $252 103%
Node Va $252 103%
Node Devoted Health Mcr Adv $253 104%
In Dept Of Correction $263 108%
Node Pphp Mcr Adv $265 109%
Us Department Of Labor $316 130%
Lutheran Advanced Network $379 155%
Lutheran Network $379 - $1,544 155%
Encore Work Comp In $454 186%
Prime Health Services $454 - $2,105 186%
Caresource $464 190%
Medicaid / KanCare $464 190%
Spreemo $500 205%
Work Comp $505 207%
Php Freedom Network $568 233%
Encore Kba Epo $606 249%
Lutheran Preferred $656 - $1,684 269%
Amish Aid $674 276%
Self Pay $674 - $1,544 276%
Three Rivers $690 283%
Encore Kba Ppo $757 311%
Php $843 - $1,122 346%
Cigna $907 - $2,807 372%
Sagamore $1,224 502%
Encore Ppo $1,304 - $2,526 535%
Multiplan $1,937 - $2,189 795%
First Health $2,105 864%
Align Network $2,246 921%
Frontpath Health Coalition $2,246 921%
Advantage Health Solutions $2,330 956%
Allied Benefit Systems $2,526 1036%
Medical Mutual Of Ohio $2,807 1151%
Parkview Healthplan Services $2,807 1151%
Value Options $2,807 1151%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals