CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $3,560
- Cash Discount Price: $3,763
- vs. Medicare Baseline: 9.99x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Saint Joseph Regional Medical Center - Plymouth is $3,560. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,763. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.99x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$3,763
Average discount available for prompt cash payment at this facility.
Insurance Median
$3,560
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: $3,763 (1056%)
Insurance Median: $3,560 (999%)
Cash: $3,763 (1056% of Medicare)
Ins. Median: $3,560 (999% 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 999% of the Medicare baseline (a markup of 899%). 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.
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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 | $191 - $3,763 | 54% |
| Blue Cross Blue Shield | $191 - $1,303 | 54% |
| Medicaid / KanCare | $191 - $756 | 54% |
| UnitedHealthcare | $191 - $1,056 | 54% |
| Medicare (plans) | $369 - $376 | 104% |
| Meridian Complete | $369 | 104% |
| Pace-Trinity Health | $369 | 104% |
| County Coroner | $384 | 108% |
| Provider Partners Health Plan Of Indiana | $406 | 114% |
| Auxiant | $554 - $4,805 | 155% |
| Physicians Health Plan Northern Indiana Health Insurance | $554 - $1,115 | 155% |
| St Joseph County Hlth Dpt | $554 | 155% |
| Caresource | $572 | 160% |
| Siho Insurance Services | $591 | 166% |
| Key Benefit Administrator | $664 - $4,059 | 186% |
| Allied Benefit Systems | $701 - $3,763 | 197% |
| Managed Health Services - Indiana | $756 | 212% |
| Mdwise | $756 | 212% |
| Custom Design Benefits | $794 | 223% |
| Geha | $1,056 | 296% |
| Healthscope | $1,056 | 296% |
| Student Insurance Cma | $1,056 | 296% |
| Blue Benefit Administrators Of Massachusetts | $1,303 | 366% |
| Blue Care Network | $1,303 | 366% |
| Blue Distinction Transplant | $1,303 | 366% |
| Blue Shield - Ca | $1,303 | 366% |
| Blue Shield - Id (Regence) | $1,303 | 366% |
| Blue Shield - Ny Highmark Northeastern | $1,303 | 366% |
| Blue Shield - Ny Highmark Western | $1,303 | 366% |
| Blue Shield - Pa (Highmark) | $1,303 | 366% |
| Blue Shield - Wa (Regence) | $1,303 | 366% |
| Plain Church Group | $1,563 | 439% |
| Notre Dame Athletic Association | $3,184 | 893% |
| Wc Notre Dame | $3,184 | 893% |
| Luminare Health (Detroit) | $3,300 - $3,473 | 926% |
| Ameriben | $3,473 | 974% |
| Asr Health Benefits | $3,763 | 1056% |
| Christian Brother Services | $3,763 | 1056% |
| Employee Benefit Management | $3,763 | 1056% |
| Medical Mutual | $3,763 | 1056% |
| Meritain | $3,763 | 1056% |
| Preferred One | $3,763 | 1056% |
| Rural Carrier Health Benefit Plan | $3,763 | 1056% |
| Webtpa | $3,763 | 1056% |
| Encore Health | $4,059 | 1139% |
| Indiana Criminal Justice Inst | $4,059 | 1139% |
| Western & Southern Financial Group | $4,059 | 1139% |
| Cigna | $4,168 | 1169% |
| Group Administrators | $4,168 | 1169% |
| Health Partners | $4,168 | 1169% |
| Mvp | $4,168 | 1169% |
| Prairie States | $4,168 | 1169% |
| Priority Health | $4,168 | 1169% |
| Professional Benefit Administrators | $4,168 | 1169% |
| Sagamore Health Network | $4,168 - $4,458 | 1169% |
| Sisco Benefits | $4,168 | 1169% |
| Unified Group Services | $4,168 | 1169% |
| Goshen Preferred Network | $4,458 - $4,979 | 1251% |
| Signature Care | $4,805 | 1348% |
| Allied National Global Care | $5,210 | 1462% |
| Asrm - Reliance Standard Life Insurance | $5,210 | 1462% |
| Avmed Health Plan | $5,210 | 1462% |
| Christian Care Ministry | $5,210 | 1462% |
| Dean Health | $5,210 | 1462% |
| Fallon Health | $5,210 | 1462% |
| Family Life Insurance Company | $5,210 | 1462% |
| Freedom Life Insurance Company | $5,210 | 1462% |
| Ghc Scw | $5,210 | 1462% |
| International Benefit Administrators | $5,210 | 1462% |
| Lifetime Benefit Solutions | $5,210 | 1462% |
| Manhattan Life | $5,210 | 1462% |
| Medi Share | $5,210 | 1462% |
| Multiplan | $5,210 | 1462% |
| Pai | $5,210 | 1462% |
| Pan-American Life | $5,210 | 1462% |
| Paramount Hmo | $5,210 | 1462% |
| Phcs | $5,210 | 1462% |
| Philadelphia American Life Insurance | $5,210 | 1462% |
| Trinity Health Share | $5,210 | 1462% |
| Bankers Life Casualty | $5,789 | 1624% |
| Bureau Of Disability | $5,789 | 1624% |
| Wc Align Network | $5,789 | 1624% |