CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Norton Scott Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,576
Cash Discount Price: $1,275
vs. Medicare Baseline: 4.42x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Norton Scott Hospital is $1,576. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,275. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.42x the Medicare baseline. Located in 1451 N Gardner St, Scottsburg, IN.

Cash / Self-Pay

$1,275

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,576

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: $1,275 (358%)

Insurance Median: $1,576 (442%)

Cash: $1,275 (358% of Medicare)

Ins. Median: $1,576 (442% 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 442% of the Medicare baseline (a markup of 342%). 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 Indiana Healthy Indiana Plan (Hip)	$194	54%
Managed Health Services (Mhs)	$194 - $1,530	54%
Managed Health Services (Mhs) Hoosier Care Connect	$194	54%
UnitedHealthcare	$194 - $3,799	54%
Caresource Indiana Hoosier Healthwise (Hhw)	$196	55%
Mdwise Hoosier Healthwise (Hhw)	$204	57%
Molina Healthcare	$368 - $379	103%
Aetna	$450	126%
Blue Cross Blue Shield	$1,300 - $3,741	365%
Managed Health Services (Mhs) Healthy Indiana Plan (Hip)	$1,530	429%
Mdwise Healthy Indiana Plan (Hip)	$1,530	429%
Communicare Advantage	$1,576	442%
Cigna	$1,600	449%
Caresource Indiana Just4Me	$2,295	644%
Multiplan	$5,099 - $5,418	1431%
Encore Health Network	$5,418	1520%
Prime Health	$5,418	1520%
Ppom	$5,609	1574%
Intercommunity Health Network (Ihn)	$5,737	1610%

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 $1,275.
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 Norton Scott 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.