CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $184
Cash Discount Price: $2,350
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Munson Healthcare Otsego Memorial Hospital is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,350. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.75x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$2,350

Average discount available for prompt cash payment at this facility.

Insurance Median

$184

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $2,350 (964%)

Insurance Median: $184 (75%)

Cash: $2,350 (964% of Medicare)

Ins. Median: $184 (75% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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
Mclaren Health Plan	$44 - $2,318	18%
Meridian	$44 - $124	18%
Molina	$44 - $257	18%
Priority Health	$44 - $455	18%
UnitedHealthcare	$44 - $2,215	18%
Blue Cross Blue Shield	$45 - $1,727	18%
Aetna	$67 - $2,240	27%
Blue Care Network	$67 - $238	27%
Hap (Health Alliance Plan)	$67 - $2,212	27%
Humana	$67 - $238	27%
Medicare (plans)	$67 - $238	27%
Michigan Amish Medical Board	$67 - $238	27%
Northern Michigan Mennonite Group	$67 - $238	27%
Asr Physicians Care Network	$100 - $2,212	41%
Cigna	$104 - $455	43%
Nomi Health	$107 - $2,212	44%
Employee Benefit Logistics	$113 - $404	46%
Munson Hospice	$852 - $1,936	350%
Hospice Of Michigan	$1,659	681%
Enterprise Group Planning/Employee Benefit Plan	$2,212	907%
Cofinity	$2,350	964%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$2,350	964%
Three Rivers Provider Network	$2,350	964%

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 $2,350.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Munson Healthcare Otsego Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.