CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Norton-King's Daughters' Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,290
Cash Discount Price: $643
vs. Medicare Baseline: 3.62x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Norton-King's Daughters' Health is $1,290. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $643. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.62x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$643

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,290

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: $643 (180%)

Insurance Median: $1,290 (362%)

Cash: $643 (180% of Medicare)

Ins. Median: $1,290 (362% 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 362% of the Medicare baseline (a markup of 262%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$102 - $1,608	29%
Blue Cross Blue Shield	$185 - $1,290	52%
Humana	$185 - $374	52%
Managed Health Services Of Kentucky	$185	52%
Passport By Molina	$185	52%
Managed Health Services Of Indiana	$194	54%
UnitedHealthcare	$194 - $2,295	54%
Managed Health Services	$385 - $580	108%
Caresource Of Kentucky	$524	147%
Caresource Of Indiana	$561	157%
Custom Design Benefits	$748 - $1,462	210%
Cigna	$2,485	697%
Encore	$2,485	697%
Quality Care Partners	$2,601	730%
Bluegrass	$2,631	738%
First Health	$2,631	738%
Healthlink	$2,631	738%
Vha/Tristate	$2,631	738%
Multiplan/Phcs	$2,689	754%
Indiana Health Network	$2,777	779%
Siho	$2,777	779%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $643.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Norton-King's Daughters' Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.