CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Southcoast Hospitals Group

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $475
Cash Discount Price: $1,457
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Southcoast Hospitals Group is $475. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,457. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.33x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$1,457

Average discount available for prompt cash payment at this facility.

Insurance Median

$475

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: $1,457 (409%)

Insurance Median: $475 (133%)

Cash: $1,457 (409% of Medicare)

Ins. Median: $475 (133% 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
Medicare (plans)	$307 - $509	86%
Wellsense Health Plan [1010202]	$399	112%
Tufts Health Public Plans [1010213]	$412 - $458	116%
Aetna	$424 - $2,218	119%
Blue Cross Blue Shield	$424 - $1,072	119%
Evercare [1010304]	$424	119%
Tufts Senior Care Options [1010315]	$424	119%
UnitedHealthcare	$424 - $586	119%
Wellsense Health Plan Senior Care Options [1020208	$428	120%
Commonwealth Care Alliance [1080501]	$437 - $441	123%
Eternal Health [1010322]	$466	131%
Fallon [1000114]	$594	167%
Wellsense Health Plan Clarity Connectorcare & Meta	$623	175%
Harvard Pilgrim [1010602]	$732	205%
Cigna	$853	239%
Tufts [1010701]	$1,218	342%
Wellpoint [1000102]	$1,328	373%
Mass General Brigham Health Plan Commercial [10122	$1,642	461%
Mass General Brigham Health Plan Connectorcare [10	$1,642	461%
Group Insurance Service Center [1013001]	$1,748	490%
Innovative Health Plan [1025001]	$1,748	490%
Priority Health [1015001]	$1,748	490%
PHCS [1000125]	$1,894	531%
First Health [1000130]	$2,218	622%

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 $1,457.
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 Southcoast Hospitals Group 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.