CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Pulaski Memorial Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,886
Cash Discount Price: $4,044
vs. Medicare Baseline: 7.74x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Pulaski Memorial Hospital is $1,886. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,044. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.74x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$4,044

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,886

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $4,044 (1659%)

Insurance Median: $1,886 (774%)

Cash: $4,044 (1659% of Medicare)

Ins. Median: $1,886 (774% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 774% of the Medicare baseline (a markup of 674%). 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
Caresource Mcaid Hhw	$119	49%
Cenpatico Mcaid Hhw - All Other Plans	$119	49%
Mdwise Mcaid Hcc	$119	49%
Mdwise Mcaid Hhw	$119	49%
Mhs Mcaid Hhw/Hcc	$119	49%
UnitedHealthcare	$119 - $4,564	49%
Blue Cross Blue Shield	$1,688 - $3,717	692%
Ambetter / Centene	$1,791	735%
Caresource Mcaid Hip	$1,791	735%
Caresource Mcare Hmo	$1,791	735%
Cenpatico Mcaid Hip	$1,791	735%
Mdwise Mcaid Hip - All Other Plans	$1,791	735%
Mhs Mcaid Hip	$1,791	735%
Humana	$1,809 - $4,645	742%
Mhs Mcare Allwell	$1,809	742%
Aetna	$2,080	853%
Caresource Exch Hmo Hix - All Other Plans	$2,239	918%
Sagamore Rose Acre	$4,304	1766%
Sagamore - All Other Plans	$4,367	1791%
Encore Ppo - All Other Plans	$4,910	2014%
Community Health Alliance - All Plans	$5,142	2109%
Encore Workers Comp	$5,199	2133%
Multiplan - All Plans	$5,199	2133%
Cigna	$5,488	2251%

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 $4,044.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pulaski Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.