CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $774
  • Cash Discount Price: $4,390
  • vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Rockcastle County Hospital, Inc. is $774. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,390. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.17x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$4,390

Average discount available for prompt cash payment at this facility.

Insurance Median
$774

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: $4,390 (1232%)
Insurance Median: $774 (217%)
Cash: $4,390 (1232% of Medicare)
Ins. Median: $774 (217% 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 217% of the Medicare baseline (a markup of 117%). 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
Tricare $246 69%
Blue Cross Blue Shield $327 - $1,000 92%
Caresource Mcr Adv-All Other Plans $327 92%
Humana $327 92%
Molina Marketplace - All Other Plans $327 92%
Molina Mcr Adv $327 92%
Signature Mcr Adv-All Plans $327 92%
Wellcare Mcr Adv-All Other Plans $327 92%
Passport Hp Hmo - All Plans $400 112%
UnitedHealthcare $704 - $774 198%
Caresource Mcaid $774 217%
Coventry Mcaid-All Plans $774 217%
Medicaid / KanCare $774 217%
Molina Mcaid $774 217%
Multiplan-All Plans $4,910 1378%
Prime Health Services-All Plans $4,910 1378%
Integrated Hp-All Plans $5,141 1442%
Corvel - All Plans $5,198 1458%
Center Care-All Plans $5,487 1539%
Cigna $5,603 1572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals