CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Joseph Health System, LLC

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $664
  • Cash Discount Price: $496
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Joseph Health System, LLC is $664. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.86x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$496

Average discount available for prompt cash payment at this facility.

Insurance Median
$664

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: $496 (139%)
Insurance Median: $664 (186%)
Cash: $496 (139% of Medicare)
Ins. Median: $664 (186% 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.

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
Amish Aid $86 - $797 24%
Self Pay $86 - $1,825 24%
Lutheran Preferred $102 - $1,991 29%
Cigna $115 - $3,319 32%
Blue Cross Blue Shield $129 - $1,517 36%
Php $143 - $1,503 40%
Lutheran Network $161 - $1,825 45%
Three Rivers $161 - $1,494 45%
Aetna $164 - $2,257 46%
Multiplan $246 - $2,589 69%
First Health $268 - $2,489 75%
Prime Health Services $268 - $2,489 75%
Align Network $286 - $2,655 80%
Frontpath Health Coalition $286 - $2,655 80%
Encore Ppo $293 - $2,987 82%
Advantage Health Solutions $296 - $2,755 83%
Allied Benefit Systems $321 - $2,987 90%
UnitedHealthcare $327 - $2,021 92%
Veterans Eval Services $329 92%
Tricare $351 98%
Medical Mutual Of Ohio $357 - $3,319 100%
Parkview Healthplan Services $357 - $3,319 100%
Php Freedom Network $357 - $920 100%
Value Options $357 - $3,319 100%
Humana $363 - $756 102%
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%
Spreemo $650 182%
Encore Work Comp In $664 186%
Work Comp $738 207%
Caresource $756 212%
Medicaid / KanCare $756 212%
Encore Kba Epo $886 249%
Encore Kba Ppo $1,107 311%
Sagamore $2,386 669%

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