CMS Price Transparency Data

MRI, brain (no contrast)

Facility: M Health Fairview St John's Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $235
Cash Discount Price: $643
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at M Health Fairview St John's Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $643. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.96x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$643

Average discount available for prompt cash payment at this facility.

Insurance Median

$235

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: $643 (264%)

Insurance Median: $235 (96%)

Cash: $643 (264% of Medicare)

Ins. Median: $235 (96% 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
Sanford Health Plan	$28 - $945	11%
Security Health Plan	$35 - $1,203	14%
America'S Ppo	$36 - $1,155	15%
First Health	$39 - $1,315	16%
Multiplan	$40 - $1,363	16%
Private Healthcare Systems	$40 - $1,363	16%
Wisconsin Physician Services	$43 - $1,444	18%
Health Partners	$48 - $1,359	20%
Primewest	$48 - $235	20%
South Country Health Alliance	$48 - $235	20%
Ucare	$49 - $540	20%
Medica	$51 - $1,398	21%
Blue Cross Blue Shield	$55 - $916	23%
Itasca Medical Care	$55 - $235	23%
UnitedHealthcare	$65 - $819	27%
Wellcare	$65 - $235	27%
Hennepin Health	$74 - $246	30%

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 $643.
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 M Health Fairview St John's 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.