CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lincolnhealth

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $619
Cash Discount Price: $3,347
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lincolnhealth is $619. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,347. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.74x the Medicare baseline. Located in 35 Miles Street, Damariscotta, ME.

Cash / Self-Pay

$3,347

Average discount available for prompt cash payment at this facility.

Insurance Median

$619

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: $3,347 (939%)

Insurance Median: $619 (174%)

Cash: $3,347 (939% of Medicare)

Ins. Median: $619 (174% 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
Aetna	$108 - $3,031	30%
Blue Cross Blue Shield	$116 - $3,028	33%
UnitedHealthcare	$116 - $3,150	33%
Wellcare	$121 - $1,323	34%
Humana	$124 - $1,272	35%
Multiplan	$196 - $3,146	55%
Harvard Pilgrim Healthcare	$206 - $3,150	58%
Community Health Options	$220 - $3,084	62%
Cigna	$3,039	853%

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 $3,347.
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 Lincolnhealth 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.