CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Woodlawn Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,062
Cash Discount Price: $3,619
vs. Medicare Baseline: 2.98x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Woodlawn Hospital is $1,062. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,619. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.98x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$3,619

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,062

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: $3,619 (1015%)

Insurance Median: $1,062 (298%)

Cash: $3,619 (1015% of Medicare)

Ins. Median: $1,062 (298% 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 298% of the Medicare baseline (a markup of 198%). 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
Blue Cross Blue Shield	$194 - $3,667	54%
Caresource Mcaid Hww	$194	54%
Mdwise Excel Hhw & Hcc	$194	54%
Mhs Mcaid Hcc	$194	54%
Mhs Mcaid Hhw	$194	54%
UnitedHealthcare	$194 - $3,667	54%
Aetna	$1,062 - $4,584	298%
Caresource Mcaid Hip	$1,062	298%
Caresource Mcr Adv	$1,062	298%
Humana	$1,062 - $3,744	298%
Mdwise Mcaid Excel Hip	$1,062	298%
Mhs Exch Mrktplce-All Other Plans	$1,062	298%
Mhs Mcaid Hip	$1,062	298%
Mhs Mcr Adv	$1,083	304%
Caresource Exch - All Other Plans	$1,380	387%
Ambetter / Centene	$1,412	396%
Partners Direct Health-All Plans	$3,281	921%
Cigna	$3,455 - $4,101	969%
Parkview Health Plans-All Plans	$3,619	1015%
Sagamore All Other Grps - All Other Plans	$4,053	1137%
Encore Comm-All Plans	$4,101	1151%
Phcs/Multiplan-All Plans	$4,487	1259%
Community Health Alliance-All Plans	$4,584	1286%

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 $3,619.
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 Woodlawn Hospital 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.