CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Melrosewakefield Healthcare

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,265
  • Cash Discount Price: $2,351
  • vs. Medicare Baseline: 3.55x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Melrosewakefield Healthcare is $1,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,351. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.55x the Medicare baseline. Located in 585 Lebanon Street, Melrose, MA.
Cash / Self-Pay
$2,351

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,265

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: $2,351 (660%)
Insurance Median: $1,265 (355%)
Cash: $2,351 (660% of Medicare)
Ins. Median: $1,265 (355% 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 355% of the Medicare baseline (a markup of 255%). 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
Harvard Pilgrim Healthcare [100241] $193 - $386 54%
Health Plans Inc [100262] $193 - $386 54%
UnitedHealthcare $193 - $4,479 54%
Meritain [100063] $250 70%
Blue Benefits Administrators [100267] $525 - $1,050 147%
Blue Cross Blue Shield $525 - $4,479 147%
Health Safety Net [500011] $531 149%
Tufts Health Plan [100263] $561 - $1,285 157%
Cigna $642 - $2,240 180%
Wellpoint [100139] $650 - $1,300 182%
Allied Benefit Systems [100015] $784 - $1,568 220%
Allied National Global Care [100107] $784 - $1,568 220%
American Postal Workers [100089] $784 - $1,568 220%
Amerihealth Caritas Nh [350007] $784 - $1,568 220%
Assurant [100020] $784 - $1,568 220%
Avmed Health Plan [100247] $784 - $1,568 220%
Benemax [100276] $784 - $1,568 220%
Care One [950007] $784 - $1,568 220%
Carecentrix Alternate [100257] $784 - $1,568 220%
Compsych [100027] $784 - $1,568 220%
Coresource [100285] $784 - $1,568 220%
Coventry [100010] $784 - $1,568 220%
Coverage Discovery [100306] $784 - $1,568 220%
D'Youville Senior Care [950003] $784 - $1,568 220%
Employee Benefit Management [100033] $784 - $1,568 220%
Eyemed [100290] $784 - $1,568 220%
First Health [100278] $784 - $1,568 220%
Geha [100039] $784 - $1,568 220%
Generic Commercial [109999] $784 - $1,568 220%
Group And Pension Administrators [100043] $784 - $1,568 220%
Ibew Local 103 [100272] $784 - $1,568 220%
Lowell Comm Health Center [950009] $784 - $1,568 220%
Medicaid / KanCare $784 - $4,479 220%
Medicare (plans) $784 - $4,479 220%
Mutual Of Omaha [100074] $784 - $1,568 220%
National Association Of Letter Carriers [100067] $784 - $1,568 220%
National Elevator Ind Hlth Benefits [100273] $784 - $1,568 220%
Norfolk County [500013] $784 - $1,568 220%
Northwood Rehabilitation & Health [950004] $784 - $1,568 220%
Nova Healthcare Administrators [100270] $784 - $1,568 220%
Palm Manor [950005] $784 - $1,568 220%
Plymouth County [500019] $784 - $1,568 220%
Spectera [100291] $784 - $1,568 220%
Tall Tree Administrators [100271] $784 - $1,568 220%
Ultra Benefits [100280] $784 - $1,568 220%
Umass Disability [500017] $784 - $1,568 220%
Tufts Health Public Plan Connectorcare [100264] $835 - $2,360 234%
Wc Acadia Insurance Company [700108] $1,244 - $2,488 349%
Wc Aig [700029] $1,244 - $2,488 349%
Wc Aim Mutual Insurance [700054] $1,244 - $2,488 349%
Wc Alternative Service Concept [700065] $1,244 - $2,488 349%
Wc Ameritrust [700066] $1,244 - $2,488 349%
Wc Arrow Mutual Liability [700063] $1,244 - $2,488 349%
Wc Atlantic Charter [700064] $1,244 - $2,488 349%
Wc Berkshire Hathaway [700046] $1,244 - $2,488 349%
Wc Boston Police And Firefighter [700061] $1,244 - $2,488 349%
Wc Broadspire [700043] $1,244 - $2,488 349%
Wc Careworks [700109] $1,244 - $2,488 349%
Wc Cbcs [700110] $1,244 - $2,488 349%
Wc Ccmsi [700055] $1,244 - $2,488 349%
Wc Chubb Group [700067] $1,244 - $2,488 349%
Wc Cic/Mcmc [700068] $1,244 - $2,488 349%
Wc City Of Boston [700111] $1,244 - $2,488 349%
Wc City Of Cambridge [700069] $1,244 - $2,488 349%
Wc City Of Chelsea [700070] $1,244 - $2,488 349%
Wc City Of Everett [700071] $1,244 - $2,488 349%
Wc City Of Lowell [700062] $1,244 - $2,488 349%
Wc City Of Lynn [700072] $1,244 - $2,488 349%
Wc City Of Medford [700073] $1,244 - $2,488 349%
Wc City Of Melrose Police [700112] $1,244 - $2,488 349%
Wc City Of Melrose [700113] $1,244 - $2,488 349%
Wc City Of Newton [700074] $1,244 - $2,488 349%
Wc City Of Peabody [700075] $1,244 - $2,488 349%
Wc City Of Revere [700076] $1,244 - $2,488 349%
Wc City Of Somerville [700077] $1,244 - $2,488 349%
Wc Cna [700048] $1,244 - $2,488 349%
Wc Commonwealth Of Mass [700056] $1,244 - $2,488 349%
Wc Consigly Construction [700079] $1,244 - $2,488 349%
Wc Constitution State Services [700114] $1,244 - $2,488 349%
Wc Continental Indemnity Co [700078] $1,244 - $2,488 349%
Wc Corvel [700115] $1,244 - $2,488 349%
Wc Cove Risk Services [700080] $1,244 - $2,488 349%
Wc Creative Risk Solutions [700081] $1,244 - $2,488 349%
Wc Crum & Forster [700082] $1,244 - $2,488 349%
Wc Demoulas Supermarket [700083] $1,244 - $2,488 349%
Wc Emc Insurance Company [700084] $1,244 - $2,488 349%
Wc Energy Of Environmental Affairs [700085] $1,244 - $2,488 349%
Wc Esis [700010] $1,244 - $2,488 349%
Wc Federated Work Comp [700012] $1,244 - $2,488 349%
Wc Future Comp [700116] $1,244 - $2,488 349%
Wc Gallagher Bassett Work Comp [700013] $1,244 - $2,488 349%
Wc Geico [700057] $1,244 - $2,488 349%
Wc Generic Workers' Comp [709999] $1,244 - $2,488 349%
Wc Gowry Group [700086] $1,244 - $2,488 349%
Wc Hartford Insurance [700058] $1,244 - $2,488 349%
Wc Hrd/Workers Compensation Unit [700087] $1,244 - $2,488 349%
Wc Liberty Mutual Work Comp [700016] $1,244 - $2,488 349%
Wc Mapfre Insurance [700089] $1,244 - $2,488 349%
Wc Mass Nahro Insurance Group Trust [700090] $1,244 - $2,488 349%
Wc Mass State Police [700091] $1,244 - $2,488 349%
Wc Mbta [700092] $1,244 - $2,488 349%
Wc Meditrol [700093] $1,244 - $2,488 349%
Wc Memic [700117] $1,244 - $2,488 349%
Wc Metlife [700094] $1,244 - $2,488 349%
Wc Miia [700095] $1,244 - $2,488 349%
Wc Ml Healthcare Services Llc [700119] $1,244 - $2,488 349%
Wc Norfolk & Dedham Group [700096] $1,244 - $2,488 349%
Wc Norguard Ins Co [700097] $1,244 - $2,488 349%
Wc One Call Medical [700060] $1,244 - $2,488 349%
Wc Plumbers Union Local No 12 [700098] $1,244 - $2,488 349%
Wc Plymouth Rock [700099] $1,244 - $2,488 349%
Wc Pma Work Comp [700031] $1,244 - $2,488 349%
Wc Progressive Direct Insurance Co [700106] $1,244 - $2,488 349%
Wc Retail Business Services Llc [700100] $1,244 - $2,488 349%
Wc Rising Medical Solution [700101] $1,244 - $2,488 349%
Wc Sedgwick [700027] $1,244 - $2,488 349%
Wc Selective Insurance Co [700118] $1,244 - $2,488 349%
Wc Sentry [700036] $1,244 - $2,488 349%
Wc Sutter House [700102] $1,244 - $2,488 349%
Wc Town Of Andover Fire Dept [700103] $1,244 - $2,488 349%
Wc Town Of Arlington [700104] $1,244 - $2,488 349%
Wc Travelers Insurance [700059] $1,244 - $2,488 349%
Wc Us Department Of Labor [700023] $1,244 - $2,488 349%
Wc Vermont Mutual Insurance Group [700105] $1,244 - $2,488 349%
Wc York Risk Services [700049] $1,244 - $2,488 349%
Wc Zurich [700034] $1,244 - $2,488 349%
Allaracare [100163] $1,297 - $2,593 364%
Claritev/Multiplan [100275] $1,971 - $3,942 553%
Cypress Benefit Administrators [100122] $1,971 - $3,942 553%
Health New England [100268] $1,971 - $3,942 553%
Patient Advocates [100307] $1,971 - $3,942 553%
Commonwealth Care Alliance [450067] $4,479 1257%
Fallon Health Connectorcare [100260] $4,479 1257%
Fallon Senior [450065] $4,479 1257%
Humana $4,479 1257%
Mass General Brigham Health Plan [100254] $4,479 1257%
Tufts Health Public Plan [350009] $4,479 1257%
Wellsense Clarity Connectorcare [100256] $4,479 1257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 585 Lebanon Street, Melrose, MA 02176
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals