CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: T J Samson Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $356
Cash Discount Price: $1,555
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at T J Samson Community Hospital is $356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,555. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.00x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$1,555

Average discount available for prompt cash payment at this facility.

Insurance Median

$356

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: $1,555 (436%)

Insurance Median: $356 (100%)

Cash: $1,555 (436% of Medicare)

Ins. Median: $356 (100% 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	$102 - $3,825	29%
Center Care Select - All Plans	$102 - $3,825	29%
Signature Health - All Plans	$102 - $358	29%
Wellcare Mcr Adv - All Other Plans	$102 - $355	29%
Molina Mcr Adv	$104 - $362	29%
Devoted Mcr Adv - All Plans	$107 - $372	30%
Humana	$107 - $774	30%
Caresource - All Plans	$132 - $532	37%
Molina Marketplace - All Other Plans	$132 - $532	37%
Aetna	$285 - $774	80%
Wellcare Mcaid	$285 - $348	80%
Molina Mcaid	$294 - $797	82%
UnitedHealthcare	$1,140	320%
Phcs/Multiplan - All Plans	$4,230	1187%
First Health - All Plans	$4,275	1199%

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 $1,555.
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 T J Samson Community 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.