CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $2,111
  • Cash Discount Price: $1,386
  • vs. Medicare Baseline: 5.92x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at The Orthopaedic Hospital of Lutheran Health Networ is $2,111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,386. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.92x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$1,386

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,111

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: $1,386 (389%)
Insurance Median: $2,111 (592%)
Cash: $1,386 (389% of Medicare)
Ins. Median: $2,111 (592% 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 592% of the Medicare baseline (a markup of 492%). 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 $327 - $2,033 92%
Tricare $351 98%
Aetna $363 - $2,625 102%
Blue Cross Blue Shield $363 - $1,517 102%
Humana $363 - $756 102%
Iu Health Plan $363 102%
Medicare (plans) $363 102%
Node Mhs Mcr Adv $363 102%
Small Business Aid $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%
Police And Sheriff $376 105%
In Dept Of Correction $384 108%
Node Pphp Mcr Adv $388 109%
Node Us Dept Of Labor $461 129%
Lutheran Advanced Network $554 155%
Lutheran Preferred $554 - $3,248 155%
Node Lutheran Three Rivers Preferred Plus 150 $554 155%
Occunet In Work Comp $554 155%
Medicaid / KanCare $582 - $756 163%
Align Network $591 166%
Node Lutheran Three Rivers Preferred Plus 175 $646 181%
One Call Work Comp $650 182%
Encore Wc $664 186%
Medrisk In Work Comp $664 186%
Prime Health Services $664 - $4,060 186%
Three Rivers Preferred In Work Comp $664 186%
Objective Surgical $720 202%
In Work Comp $738 207%
Lutheran Network $738 207%
Managed Health Services $738 - $756 207%
Caresource $756 212%
Mhs $756 212%
Encore Kba Epo $886 249%
Php Freedom Network $920 258%
Encore Kba Ppo $1,107 311%
Encore Ppo $1,260 354%
Amish Aid $1,301 - $1,462 365%
Self Pay $1,301 - $1,462 365%
Physicians Health Plan $1,331 - $2,100 373%
Cigna $1,691 - $5,413 474%
Three Rivers Preferred $1,927 - $2,436 541%
Sagamore $2,317 - $2,604 650%
Multiplan $3,324 - $4,222 933%
First Health $3,710 - $4,168 1041%
Encore $3,854 - $4,330 1081%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals