CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Essentia Health Sandstone

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $2,689
  • Cash Discount Price: $2,901
  • vs. Medicare Baseline: 7.54x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Essentia Health Sandstone is $2,689. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,901. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.54x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.
Cash / Self-Pay
$2,901

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,689

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: $2,901 (814%)
Insurance Median: $2,689 (754%)
Cash: $2,901 (814% of Medicare)
Ins. Median: $2,689 (754% 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 754% of the Medicare baseline (a markup of 654%). 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
Itasca Med Care $357 100%
Primewest $371 104%
Blue Cross Blue Shield $1,507 - $3,153 423%
Blue Plus Pmap Pcc Prime $1,507 - $2,159 423%
Medica Access $1,563 - $2,446 439%
Healthpartners Care Pmap $1,578 443%
Sanford Healthplan $1,684 - $1,773 472%
Advocare/Security Health $1,845 518%
Freedom Blue Ppo $1,845 518%
Healthpartners Care Msho / Mcr Adv $1,845 518%
Imcare Msho Pcc Prime $1,845 518%
Imcare Msho Ref Req $1,845 518%
Medica Advantage Solutions $1,845 518%
Medica Msho/Dual Solutions $1,845 518%
Medica Prime Solution Group $1,845 518%
Medicare (plans) $1,845 518%
Nd Va Administration $1,845 518%
Platinum Blue/Vantage Blue $1,845 518%
Primewest Msho $1,845 518%
Secure Blue Msho $1,845 518%
Ubh Cost Plan $1,845 518%
Ubh Msho $1,845 518%
Ucare Msho $1,845 518%
UnitedHealthcare $1,845 - $3,573 518%
Ucare $2,583 725%
Healthpartners $2,654 - $3,129 745%
Medica $2,807 - $3,121 788%
Medica Uplan $2,807 788%
Wea $2,827 - $3,023 793%
America'S Ppo $3,043 854%
Cigna $3,062 - $3,129 859%
Healthpartners Pcc Prime $3,062 - $3,129 859%
Medica Choice $3,215 902%
Wps $3,259 - $3,298 914%
Aetna $3,337 936%
Security Health $3,926 1101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 705 Lundorff Drive South, Sandstone, MN 55072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals