CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Trinity Health Oakland Hospital
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $5,333
- Cash Discount Price: $5,097
- vs. Medicare Baseline: 14.96x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Trinity Health Oakland Hospital is $5,333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,097. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 14.96x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$5,097
Average discount available for prompt cash payment at this facility.
Insurance Median
$5,333
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: $5,097 (1430%)
Insurance Median: $5,333 (1496%)
Cash: $5,097 (1430% of Medicare)
Ins. Median: $5,333 (1496% 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 1496% of the Medicare baseline (a markup of 1396%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $191 - $195 | 54% |
| Blue Cross Blue Shield | $195 - $345 | 55% |
| Aetna | $270 - $3,552 | 76% |
| Geha | $270 - $5,882 | 76% |
| Medical Mutual | $270 | 76% |
| Meritain | $270 | 76% |
| Blue Care Network Advantage | $341 | 96% |
| Medicare (plans) | $341 - $348 | 96% |
| Bcn Domestic | $345 | 97% |
| Blue Benefit Administrators Of Massachusetts | $345 | 97% |
| Blue Care Network | $345 | 97% |
| Blue Distinction Transplant | $345 | 97% |
| Blue Shield - Ca | $345 | 97% |
| Blue Shield - Id (Regence) | $345 | 97% |
| Blue Shield - Ny Highmark Northeastern | $345 | 97% |
| Blue Shield - Ny Highmark Western | $345 | 97% |
| Blue Shield - Pa (Highmark) | $345 | 97% |
| Blue Shield - Wa (Regence) | $345 | 97% |
| Health Choices | $345 - $5,756 | 97% |
| Kaiser Domestic | $345 | 97% |
| Align Senior Care | $348 | 98% |
| Hospice Advantage | $348 | 98% |
| UnitedHealthcare | $358 - $5,882 | 100% |
| Cca - Zing Health | $368 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $392 | 110% |
| Molina Marketplace | $452 | 127% |
| Health Cost Solutions | $539 | 151% |
| Vitalcore | $539 | 151% |
| Wellpath | $539 | 151% |
| U Of M Health Plan | $709 | 199% |
| Priority Health | $766 - $851 | 215% |
| Employee Benefit Logistic | $802 | 225% |
| Asr Health Benefits | $1,052 | 295% |
| Caresource | $1,052 | 295% |
| Hap | $1,052 - $5,710 | 295% |
| Varipro | $1,052 | 295% |
| Wc Accident Fund | $2,380 | 668% |
| Wc Advantage | $2,380 | 668% |
| Wc Aig | $2,380 | 668% |
| Wc Allied | $2,380 | 668% |
| Wc Amerisure | $2,380 | 668% |
| Wc Amtrust | $2,380 | 668% |
| Wc Asu Risk Mgt | $2,380 | 668% |
| Wc Berkley Admin | $2,380 | 668% |
| Wc Broadspire | $2,380 | 668% |
| Wc Bunch & Associates | $2,380 | 668% |
| Wc Ccmsi | $2,380 | 668% |
| Wc Emc Insurance Company | $2,380 | 668% |
| Wc Esis | $2,380 | 668% |
| Wc Fcci | $2,380 | 668% |
| Wc Federated | $2,380 | 668% |
| Wc Gallagher Bassett | $2,380 | 668% |
| Wc Genex Care For Ohio | $2,380 | 668% |
| Wc Guard Insurance Company | $2,380 | 668% |
| Wc Hartford | $2,380 | 668% |
| Wc Liberty Mutual | $2,380 | 668% |
| Wc Meijers | $2,380 | 668% |
| Wc Michigan | $2,380 | 668% |
| Wc Mitchell Frankenmuth | $2,380 | 668% |
| Wc Pma | $2,380 | 668% |
| Wc Sedgwick | $2,380 | 668% |
| Wc Sentry | $2,380 | 668% |
| Wc Travelers | $2,380 | 668% |
| Wc Tristar | $2,380 | 668% |
| Wc Walmart | $2,380 | 668% |
| Wc Zurich | $2,380 | 668% |
| Acs Benefit Services | $3,450 | 968% |
| Allied Benefit Systems | $3,450 | 968% |
| Claimchoice Adminstrators | $3,450 | 968% |
| Consociate | $3,450 | 968% |
| Cypress Benefit Administrators | $3,450 | 968% |
| Forest County Potawatomi | $3,450 | 968% |
| Health Smart | $3,450 | 968% |
| Healthgram | $3,450 | 968% |
| Healthscope | $3,450 | 968% |
| Secureone Preferred United Plans | $3,450 | 968% |
| Sisco Benefits | $3,450 | 968% |
| The Health Plan | $3,450 | 968% |
| Trustmark Small Business Benefits | $3,450 | 968% |
| Unified Group Services | $3,450 | 968% |
| Webtpa | $3,450 | 968% |
| Mclaren Health | $3,770 - $4,112 | 1058% |
| Carelon Behavioral Health | $3,921 | 1100% |
| Magellan Behavioral Health | $4,705 | 1320% |
| 1199 National Benefit Fund | $5,333 | 1496% |
| Allied National Global Care | $5,333 | 1496% |
| Asrm - Reliance Standard Life Insurance | $5,333 | 1496% |
| Christian Care Ministry | $5,333 | 1496% |
| Dean Health | $5,333 | 1496% |
| Fallon Health | $5,333 | 1496% |
| Family Life Insurance Company | $5,333 | 1496% |
| Ghc Scw | $5,333 | 1496% |
| Group Pension Administrators | $5,333 | 1496% |
| International Benefit Administrators | $5,333 | 1496% |
| Lifetime Benefit Solutions | $5,333 | 1496% |
| Manhattan Life | $5,333 | 1496% |
| Medi Share | $5,333 | 1496% |
| Multiplan | $5,333 | 1496% |
| Mvp | $5,333 | 1496% |
| Pai | $5,333 | 1496% |
| Pan-American Life | $5,333 | 1496% |
| Paramount Hmo | $5,333 | 1496% |
| Phcs | $5,333 | 1496% |
| Trinity Health Share | $5,333 | 1496% |
| Health Partners | $5,710 | 1602% |
| Tufts Health Plan | $5,710 | 1602% |
| Access Health | $5,756 | 1615% |
| Acclaim | $5,756 | 1615% |
| Administrative Concepts | $5,756 | 1615% |
| Allegeant | $5,756 | 1615% |
| Ameriben | $5,756 | 1615% |
| American Family | $5,756 | 1615% |
| American Healthcare Alliance | $5,756 | 1615% |
| American National | $5,756 | 1615% |
| American Republic | $5,756 | 1615% |
| Amerihealth | $5,756 | 1615% |
| Aultcare | $5,756 | 1615% |
| Automated Benefit Services | $5,756 | 1615% |
| Auxiant | $5,756 | 1615% |
| Benefit Administrative Systems,Llc | $5,756 | 1615% |
| Boon Chapman | $5,756 | 1615% |
| Cam Administrative Services | $5,756 | 1615% |
| Christian Brother Services | $5,756 | 1615% |
| Christian Brothers Holy Cross | $5,756 | 1615% |
| Comprehensive Benefits | $5,756 | 1615% |
| Continental Life Insurance | $5,756 | 1615% |
| Custom Benefit Administrators | $5,756 | 1615% |
| Employee Benefit Concepts | $5,756 | 1615% |
| Employee Benefit Management | $5,756 | 1615% |
| Enterprise Group Planning | $5,756 | 1615% |
| Freedom Life Insurance Company | $5,756 | 1615% |
| Group Administrators | $5,756 | 1615% |
| Group Marketing Services | $5,756 | 1615% |
| Guardian | $5,756 | 1615% |
| Health America | $5,756 | 1615% |
| Healthcare Management Admin | $5,756 | 1615% |
| Healthez | $5,756 | 1615% |
| Humana | $5,756 | 1615% |
| Insight | $5,756 | 1615% |
| Intercare | $5,756 | 1615% |
| Jfp Benefit Management | $5,756 | 1615% |
| Jp Farley Corporation | $5,756 | 1615% |
| Key Benefit Administrator | $5,756 | 1615% |
| Liberty Union Life Assurance Co | $5,756 | 1615% |
| Lucent Health | $5,756 | 1615% |
| Luminare Health | $5,756 | 1615% |
| Luminare Health (Detroit) | $5,756 | 1615% |
| Magnacare | $5,756 | 1615% |
| Medben | $5,756 | 1615% |
| Medcost | $5,756 | 1615% |
| Mutual Health Services | $5,756 | 1615% |
| Mutual Of Omaha | $5,756 | 1615% |
| Ncas | $5,756 | 1615% |
| Nippon Life Ins | $5,756 | 1615% |
| Nova | $5,756 | 1615% |
| Painters Union Insurance Fund | $5,756 | 1615% |
| Physicians Mutual | $5,756 | 1615% |
| Plumbers Local 98 Insurance Fund | $5,756 | 1615% |
| Prairie States | $5,756 | 1615% |
| Preferred One | $5,756 | 1615% |
| Primary Physician Care | $5,756 | 1615% |
| Professional Benefit Administrators | $5,756 | 1615% |
| Siho Insurance Services | $5,756 | 1615% |
| The Loomis Company | $5,756 | 1615% |
| Unicare | $5,756 | 1615% |
| Us Health And Life | $5,756 | 1615% |
| Valenz | $5,756 | 1615% |
| Western & Southern Financial Group | $5,756 | 1615% |
| Wps | $5,756 | 1615% |
| Cigna | $5,812 | 1631% |
| Coventry | $5,911 | 1658% |
| First Health | $5,911 | 1658% |
| Prime Health Services | $6,274 | 1760% |
| Three Rivers Provider Network | $7,058 | 1980% |
| Cmh Detroit Wayne Integrated Health Network | $7,842 | 2200% |
| Cmh Lenawee County | $7,842 | 2200% |
| Cmh Livingston County | $7,842 | 2200% |
| Cmh Misc | $7,842 | 2200% |
| Cmh Monroe County | $7,842 | 2200% |
| Cmh Oakland County | $7,842 | 2200% |
| Cmh Washtenaw County | $7,842 | 2200% |