CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Mercy Health Lakeshore Campus
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $2,824
- Cash Discount Price: $2,051
- vs. Medicare Baseline: 7.92x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Health Lakeshore Campus is $2,824. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,051. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.92x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$2,051
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,824
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: $2,051 (575%)
Insurance Median: $2,824 (792%)
Cash: $2,051 (575% of Medicare)
Ins. Median: $2,824 (792% 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 792% of the Medicare baseline (a markup of 692%). 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $263 - $773 | 74% |
| Medicaid / KanCare | $263 - $268 | 74% |
| Wellpath | $522 | 146% |
| Access Health | $552 | 155% |
| U Of M Health Plan | $709 - $2,824 | 199% |
| Blue Care Network Advantage | $773 | 217% |
| Medicare (plans) | $773 | 217% |
| Aetna | $789 | 221% |
| Align Senior Care | $789 | 221% |
| Correctional Recovery | $789 | 221% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $889 | 249% |
| Oscar | $969 | 272% |
| Vitalcore | $1,051 | 295% |
| UnitedHealthcare | $1,105 - $2,840 | 310% |
| Molina Marketplace | $1,312 | 368% |
| Hospice Of Michigan | $1,735 | 487% |
| Nomi Health | $1,767 | 496% |
| Hap | $2,364 - $2,896 | 663% |
| Wc Accident Fund | $2,488 | 698% |
| Wc Advantage | $2,488 | 698% |
| Wc Aig | $2,488 | 698% |
| Wc Allied | $2,488 | 698% |
| Wc Amerisure | $2,488 | 698% |
| Wc Amtrust | $2,488 | 698% |
| Wc Asu Risk Mgt | $2,488 | 698% |
| Wc Berkley Admin | $2,488 | 698% |
| Wc Broadspire | $2,488 | 698% |
| Wc Bunch & Associates | $2,488 | 698% |
| Wc Ccmsi | $2,488 | 698% |
| Wc Emc Insurance Company | $2,488 | 698% |
| Wc Esis | $2,488 | 698% |
| Wc Fcci | $2,488 | 698% |
| Wc Federated | $2,488 | 698% |
| Wc Gallagher Bassett | $2,488 | 698% |
| Wc Genex Care For Ohio | $2,488 | 698% |
| Wc Guard Insurance Company | $2,488 | 698% |
| Wc Hartford | $2,488 | 698% |
| Wc Liberty Mutual | $2,488 | 698% |
| Wc Meijers | $2,488 | 698% |
| Wc Michigan | $2,488 | 698% |
| Wc Mitchell Frankenmuth | $2,488 | 698% |
| Wc Pma | $2,488 | 698% |
| Wc Sedgwick | $2,488 | 698% |
| Wc Sentry | $2,488 | 698% |
| Wc Travelers | $2,488 | 698% |
| Wc Tristar | $2,488 | 698% |
| Wc Walmart | $2,488 | 698% |
| Wc Zurich | $2,488 | 698% |
| Asr Health Benefits | $2,627 | 737% |
| 1199 National Benefit Fund | $2,713 | 761% |
| Allied National Global Care | $2,713 | 761% |
| Asrm - Reliance Standard Life Insurance | $2,713 | 761% |
| Christian Care Ministry | $2,713 | 761% |
| Dean Health | $2,713 | 761% |
| Fallon Health | $2,713 | 761% |
| Family Life Insurance Company | $2,713 | 761% |
| Ghc Scw | $2,713 | 761% |
| Group Pension Administrators | $2,713 | 761% |
| International Benefit Administrators | $2,713 | 761% |
| Lifetime Benefit Solutions | $2,713 | 761% |
| Manhattan Life | $2,713 | 761% |
| Medi Share | $2,713 | 761% |
| Multiplan | $2,713 | 761% |
| Mvp | $2,713 | 761% |
| Pai | $2,713 | 761% |
| Pan-American Life | $2,713 | 761% |
| Paramount Hmo | $2,713 | 761% |
| Phcs | $2,713 | 761% |
| Trinity Health Share | $2,713 | 761% |
| Cigna | $2,738 | 768% |
| Caresource | $2,815 | 790% |
| Acclaim | $2,824 | 792% |
| Administrative Concepts | $2,824 | 792% |
| Allegeant | $2,824 | 792% |
| Allied Benefit Systems | $2,824 | 792% |
| Ameriben | $2,824 | 792% |
| American Family | $2,824 | 792% |
| American Healthcare Alliance | $2,824 | 792% |
| American Republic | $2,824 | 792% |
| Amerihealth | $2,824 | 792% |
| Aultcare | $2,824 | 792% |
| Automated Benefit Services | $2,824 | 792% |
| Auxiant | $2,824 | 792% |
| Benefit Administrative Systems,Llc | $2,824 | 792% |
| Boon Chapman | $2,824 | 792% |
| Cam Administrative Services | $2,824 | 792% |
| Christian Brother Services | $2,824 | 792% |
| Christian Brothers Holy Cross | $2,824 | 792% |
| Claimchoice Adminstrators | $2,824 | 792% |
| Comprehensive Benefits | $2,824 | 792% |
| Consociate | $2,824 | 792% |
| Continental Life Insurance | $2,824 | 792% |
| Custom Benefit Administrators | $2,824 | 792% |
| Cypress Benefit Administrators | $2,824 | 792% |
| Employee Benefit Concepts | $2,824 | 792% |
| Employee Benefit Management | $2,824 | 792% |
| Enterprise Group Planning | $2,824 | 792% |
| Forest County Potawatomi | $2,824 | 792% |
| Freedom Life Insurance Company | $2,824 | 792% |
| Group Administrators | $2,824 | 792% |
| Group Marketing Services | $2,824 | 792% |
| Guardian | $2,824 | 792% |
| Health America | $2,824 | 792% |
| Health Choices | $2,824 | 792% |
| Health Smart | $2,824 | 792% |
| Healthez | $2,824 | 792% |
| Healthgram | $2,824 | 792% |
| Healthscope | $2,824 | 792% |
| Humana | $2,824 | 792% |
| Insight | $2,824 | 792% |
| Intercare | $2,824 | 792% |
| Jfp Benefit Management | $2,824 | 792% |
| Jp Farley Corporation | $2,824 | 792% |
| Key Benefit Administrator | $2,824 | 792% |
| Liberty Union Life Assurance Co | $2,824 | 792% |
| Lucent Health | $2,824 | 792% |
| Luminare Health | $2,824 | 792% |
| Luminare Health (Detroit) | $2,824 | 792% |
| Medben | $2,824 | 792% |
| Medcost | $2,824 | 792% |
| Medical Mutual | $2,824 | 792% |
| Mutual Health Services | $2,824 | 792% |
| Mutual Of Omaha | $2,824 | 792% |
| Ncas | $2,824 | 792% |
| Nippon Life Ins | $2,824 | 792% |
| Nova | $2,824 | 792% |
| Painters Union Insurance Fund | $2,824 | 792% |
| Physicians Mutual | $2,824 | 792% |
| Plumbers Local 98 Insurance Fund | $2,824 | 792% |
| Prairie States | $2,824 | 792% |
| Primary Physician Care | $2,824 | 792% |
| Professional Benefit Administrators | $2,824 | 792% |
| Secureone Preferred United Plans | $2,824 | 792% |
| The Loomis Company | $2,824 | 792% |
| Trustmark Small Business Benefits | $2,824 | 792% |
| Unicare | $2,824 | 792% |
| Unified Group Services | $2,824 | 792% |
| Us Health And Life | $2,824 | 792% |
| Valenz | $2,824 | 792% |
| Varipro | $2,824 - $2,896 | 792% |
| Western & Southern Financial Group | $2,824 | 792% |
| Wps | $2,824 | 792% |
| Geha | $2,840 | 797% |
| Priority Health | $2,843 | 798% |
| First Health | $2,852 | 800% |