CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $299
Cash Discount Price: $4,063
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Munson Healthcare Otsego Memorial Hospital is $299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,063. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.84x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$4,063

Average discount available for prompt cash payment at this facility.

Insurance Median

$299

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: $4,063 (1140%)

Insurance Median: $299 (84%)

Cash: $4,063 (1140% of Medicare)

Ins. Median: $299 (84% 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
Mclaren Health Plan	$69 - $4,008	19%
Meridian	$69 - $182	19%
Molina	$69 - $375	19%
Priority Health	$69 - $764	19%
UnitedHealthcare	$69 - $3,829	19%
Blue Cross Blue Shield	$70 - $2,985	20%
Blue Care Network	$103 - $348	29%
Hap (Health Alliance Plan)	$103 - $3,824	29%
Humana	$103 - $348	29%
Medicare (plans)	$103 - $348	29%
Michigan Amish Medical Board	$103 - $348	29%
Northern Michigan Mennonite Group	$103 - $348	29%
Aetna	$105 - $3,872	29%
Asr Physicians Care Network	$155 - $3,824	43%
Cigna	$163 - $764	46%
Nomi Health	$166 - $3,824	47%
Employee Benefit Logistics	$176 - $591	49%
Munson Hospice	$852 - $3,346	239%
Hospice Of Michigan	$2,868	805%
Enterprise Group Planning/Employee Benefit Plan	$3,824	1073%
Cofinity	$4,063	1140%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$4,063	1140%
Three Rivers Provider Network	$4,063	1140%

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 $4,063.
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 Munson Healthcare Otsego Memorial Hospital 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.