CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: McLaren Northern Michigan

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $198
Cash Discount Price: $1,147
vs. Medicare Baseline: 0.56x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at McLaren Northern Michigan is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,147. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.56x the Medicare baseline. Located in 416 Connable Ave, Petoskey, MI.

Cash / Self-Pay

$1,147

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $1,147 (322%)

Insurance Median: $198 (56%)

Cash: $1,147 (322% of Medicare)

Ins. Median: $198 (56% 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
Medicaid / KanCare	$69 - $201	19%
Humana	$103 - $348	29%
Medicare (plans)	$103 - $557	29%
U Of M Health Plan	$119	33%
UnitedHealthcare	$134 - $3,219	38%
Aetna	$140	39%
Priority Health	$157 - $2,602	44%
Blue Cross Blue Shield	$173 - $888	49%
Mclaren Commercial Ins	$237 - $1,284	66%
Tricare	$315	88%
Mi Amish Medical Board	$348	98%
Cofinity Auto	$662	186%
Workers Compensation	$1,494	419%
Cofinity Group 15892 & 15893	$2,533	711%

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 $1,147.
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 McLaren Northern Michigan 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.