CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: M Health Fairview St John's Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $526
Cash Discount Price: $695
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at M Health Fairview St John's Hospital is $526. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $695. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.48x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$695

Average discount available for prompt cash payment at this facility.

Insurance Median

$526

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: $695 (195%)

Insurance Median: $526 (148%)

Cash: $695 (195% of Medicare)

Ins. Median: $526 (148% 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
Security Health Plan	$35 - $2,174	10%
America'S Ppo	$37 - $2,087	10%
First Health	$40 - $2,377	11%
Multiplan	$41 - $2,464	12%
Private Healthcare Systems	$41 - $2,464	12%
Wisconsin Physician Services	$44 - $2,608	12%
Health Partners	$74 - $1,359	21%
Primewest	$74 - $347	21%
Sanford Health Plan	$74 - $1,707	21%
South Country Health Alliance	$74 - $347	21%
Ucare	$76 - $865	21%
Medica	$79 - $1,398	22%
Blue Cross Blue Shield	$85 - $1,117	24%
Itasca Medical Care	$85 - $347	24%
UnitedHealthcare	$101 - $1,340	28%
Wellcare	$101 - $347	28%
Hennepin Health	$114 - $363	32%

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 $695.
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 M Health Fairview St John's 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.