CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Northwest Health - Starke

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $949
  • Cash Discount Price: $1,898
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Northwest Health - Starke is $949. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,898. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.66x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$1,898

Average discount available for prompt cash payment at this facility.

Insurance Median
$949

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: $1,898 (533%)
Insurance Median: $949 (266%)
Cash: $1,898 (533% of Medicare)
Ins. Median: $949 (266% 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 266% of the Medicare baseline (a markup of 166%). 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
UnitedHealthcare $350 - $3,277 98%
Tricare $351 98%
Node Champva $369 104%
Aetna $389 - $4,004 109%
Blue Cross Blue Shield $389 - $1,500 109%
Humana $389 - $756 109%
Medicare (plans) $389 109%
Managed Health Services $395 - $791 111%
Node Hospice Non Par Agree $395 111%
Node Va $395 111%
Node Devoted Health Mcr Adv $397 111%
In Dept Of Correction $411 115%
Node Pphp Mcr Adv $415 116%
Us Department Of Labor $494 139%
Caresource $582 - $756 163%
One Call $650 182%
Encore $712 - $4,027 200%
Medicaid / KanCare $756 212%
Mhs $756 212%
Indiana Workers Comp $791 222%
Lutheran Network $791 - $4,073 222%
Encore Kba Epo $949 266%
Magnacare Ma $949 266%
Encore Kba Ppo $1,186 333%
Lutheran $1,250 351%
Self Pay $1,250 - $2,546 351%
Medpartners $1,551 435%
Physicians Health Plan $1,912 536%
Alpha Baking $2,083 584%
Php $2,785 781%
Multiplan Inc $3,703 - $4,166 1039%
Cigna $3,842 1078%
Coventry First Health $4,004 1123%
Sagamore Health Network $4,073 1143%
Community Health Alliance $4,166 1169%
Ppom $4,351 1221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals