CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $586
Cash Discount Price: $4,079
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UMass Memorial Healthalliance Hospitals is $586. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,079. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.64x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$4,079

Average discount available for prompt cash payment at this facility.

Insurance Median

$586

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: $4,079 (1144%)

Insurance Median: $586 (164%)

Cash: $4,079 (1144% of Medicare)

Ins. Median: $586 (164% 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
Hsno/Free Care [10801]	$294	82%
Champva [11001]	$382	107%
Cigna	$423 - $3,323	119%
Correctional Care [11003]	$423	119%
Institution [10406]	$423 - $2,162	119%
Medicaid / KanCare	$423 - $2,121	119%
Medicare (plans)	$423	119%
Tufts Dual [10111]	$423	119%
Tufts Us Family [11203]	$423	119%
Blue Cross Blue Shield	$437 - $1,069	123%
Aetna	$444	125%
Commonwealth Care Mcr [10115]	$444	125%
Fallon Mcr Supp [20202]	$444	125%
Harvard Pilgrim Mcr [10106]	$444	125%
Mgb Mcr [10124]	$444	125%
Tufts Mcr [10112]	$444	125%
UnitedHealthcare	$444 - $4,079	125%
Senior Whole Health [10110]	$453	127%
Tufts Connectorcare [10507]	$720	202%
Tufts [11201]	$971	272%
Workers Compensation [20501]	$1,010	283%
Wellpoint [11112]	$1,117	313%
Hne [11108]	$2,276	639%
First Health Network [11120]	$3,059	858%
Multiplan [11109]	$3,059	858%
Connecticare [11105]	$4,079	1144%
Fallon Carelon Hlth [28]	$4,079	1144%
Fallon Mcaid Carelon Hlth [29]	$4,079	1144%
Grants [20507]	$4,079	1144%

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 $4,079.
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 UMass Memorial Healthalliance Hospitals 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.