CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $350
Cash Discount Price: $2,241
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Ascension Providence Hospital, Southfield and Novi is $350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,241. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.98x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$2,241

Average discount available for prompt cash payment at this facility.

Insurance Median

$350

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: $2,241 (629%)

Insurance Median: $350 (98%)

Cash: $2,241 (629% of Medicare)

Ins. Median: $350 (98% 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
Blue Caid Michigan	$203	57%
Harbor Health Mcd	$203	57%
Medicaid / KanCare	$203 - $350	57%
Molina Health	$203 - $239	57%
Total Health Care	$203	57%
UnitedHealthcare	$203	57%
Priority Ppo	$263	74%
Amerihealth Vip Care Mcr	$301 - $346	84%
Priority Health Hmo	$308	86%
Aetna	$350 - $882	98%
Auto Insurance	$350	98%
Jvhl - Mcr Replacement	$350	98%
Mcr Replacement	$350	98%
Veterans Choice	$350	98%
Humana	$353	99%
Meridian Wellcare	$367	103%
Molina Advantage	$367	103%
Bc Metro Detroit Epo	$393 - $484	110%
Ambetter / Centene	$437	123%
Molina Marketplace	$437	123%
Bcn Local Network Southeast	$442 - $484	124%
Bc Metro Detroit Hmo	$478 - $484	134%
Blue Care Network	$478 - $484	134%
Blue Cross Blue Shield	$478 - $484	134%
Smart Health	$483	136%
Hap Alliance Health	$484	136%
Hap Hmo Pos	$484	136%
Hap Preferred	$570	160%

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 $2,241.
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 Ascension Providence Hospital, Southfield and Novi 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.