CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,406
Cash Discount Price: $5,257
vs. Medicare Baseline: 3.94x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UMass Memorial Health - Harrington Hospital is $1,406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,257. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.94x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$5,257

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,406

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: $5,257 (1475%)

Insurance Median: $1,406 (394%)

Cash: $5,257 (1475% of Medicare)

Ins. Median: $1,406 (394% 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 394% of the Medicare baseline (a markup of 294%). 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
Cigna	$423 - $4,058	119%
Institution [10406]	$423	119%
Mgb Mcr [10124]	$423	119%
Tufts Us Family [11203]	$423	119%
Champva [11001]	$424	119%
Blue Cross Blue Shield	$437 - $1,695	123%
Aetna	$444 - $5,257	125%
Commonwealth Care Alliance [10103]	$444	125%
Fallon Mcr Supp [20202]	$444	125%
Fallon Mcr [10105]	$444	125%
Tufts Mcr [10112]	$444	125%
UnitedHealthcare	$444 - $5,257	125%
Senior Whole Health [10110]	$453	127%
Hsno/Free Care [10801]	$681	191%
Tufts Connectorcare [10507]	$720	202%
Workers Compensation [20501]	$1,010	283%
Wellpoint [11112]	$1,117	313%
Medicaid / KanCare	$2,734	767%
Hne [11108]	$3,421	960%
First Health Network [11120]	$3,943	1106%
Evernorth Behavioral Health [27]	$4,206	1180%
Connecticare [11105]	$5,257	1475%
Fallon Carelon Hlth [28]	$5,257	1475%
Fallon Mcaid Carelon Hlth [29]	$5,257	1475%
Grants [20507]	$5,257	1475%
Masshealth Mcd Mbhp [38]	$5,257	1475%
Wellsense Mcaid Carelon Hlth [21]	$5,257	1475%

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 $5,257.
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 Health - Harrington 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.