CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Promedica Monroe Regional Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $644
  • Cash Discount Price: $3,020
  • vs. Medicare Baseline: 1.81x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Promedica Monroe Regional Hospital is $644. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,020. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.81x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.
Cash / Self-Pay
$3,020

Average discount available for prompt cash payment at this facility.

Insurance Median
$644

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: $3,020 (847%)
Insurance Median: $644 (181%)
Cash: $3,020 (847% of Medicare)
Ins. Median: $644 (181% 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.

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
Meridian $191 54%
Priority Health $191 - $2,555 54%
Blue Cross Blue Shield $201 - $2,610 56%
Aetna $206 - $3,271 58%
Molina Healthcare Of Michigan $206 58%
UnitedHealthcare $210 - $3,773 59%
Amerihealth $268 75%
Paramount Healthcare Inc $285 - $3,531 80%
Health Alliance Plan $292 - $3,810 82%
Humana $301 - $356 84%
Veterans Affairs $352 99%
Frontpath $2,695 756%
Encore Health Network $3,252 912%
Health Ohio Network, Llc $3,252 912%
Cofinity $3,313 929%
Multiplan $4,181 1173%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 718 N Macomb St, Monroe, MI 48162
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals