CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Memorial Hospital and Health Care Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $297
Cash Discount Price: $151
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Memorial Hospital and Health Care Center is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.83x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$297

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: $151 (42%)

Insurance Median: $297 (83%)

Cash: $151 (42% of Medicare)

Ins. Median: $297 (83% 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.

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
Blue Cross Blue Shield	$84 - $593	24%
Aetna	$101 - $1,051	28%
Caresource In Marketplace	$101 - $468	28%
Humana	$101 - $374	28%
Mdwise	$101 - $300	28%
Mhs Hoosier Care Connect	$101 - $300	28%
Tricare	$101 - $318	28%
Chamber Care	$103	29%
UnitedHealthcare	$103 - $1,122	29%
Immergrun	$121 - $352	34%
Ambetter / Centene	$131 - $486	37%
Onecare	$131 - $381	37%
Siho	$131 - $381	37%
Noncontracted	$161 - $599	45%
Patoka Valley	$178 - $1,342	50%
Encore	$181 - $1,533	51%
Encore Elite +	$181 - $1,533	51%
Cigna	$354 - $1,051	99%
Sagamore	$354 - $1,051	99%

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 $151.
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 Memorial Hospital and Health Care Center 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.