CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Tug Valley Arh Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,137
  • Cash Discount Price: $5,938
  • vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Tug Valley Arh Regional Medical Center is $1,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,938. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.19x the Medicare baseline. Located in 260 Hospital Drive, South Williamson, KY.
Cash / Self-Pay
$5,938

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,137

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: $5,938 (1666%)
Insurance Median: $1,137 (319%)
Cash: $5,938 (1666% of Medicare)
Ins. Median: $1,137 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Aetna $206 - $8,906 58%
Blue Cross Blue Shield $206 - $1,514 58%
Humana $206 - $1,514 58%
The Health Plan $206 58%
UnitedHealthcare $206 - $7,095 58%
Wellcare Of Kentucky $206 - $2,276 58%
Passport Molina $1,514 425%
Caresoure Kentucky $5,938 1666%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 260 Hospital Drive, South Williamson, KY 41503
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals