CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Perham Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,538
Cash Discount Price: $2,776
vs. Medicare Baseline: 4.32x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Perham Health is $1,538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,776. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.32x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$2,776

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,538

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: $2,776 (779%)

Insurance Median: $1,538 (432%)

Cash: $2,776 (779% of Medicare)

Ins. Median: $1,538 (432% 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 432% of the Medicare baseline (a markup of 332%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medica Mn (Msho)	$848	238%
Medica Mn Senior Hp/Outside Mn	$848	238%
Blue Cross Blue Shield	$1,216 - $1,452	341%
Health Partners Mcr Adv	$1,452	407%
Humana	$1,452	407%
Medica Mcr Adv	$1,452	407%
Medicare (plans)	$1,452 - $1,614	407%
Ucare Mn Senior Health Options	$1,452	407%
UnitedHealthcare	$1,495 - $3,331	419%
Ucare Mn Special Needs Basic Care Dual	$1,525	428%
Ucare Mn Medical Assistance	$1,538	432%
Ucare Mn Minnesota Care	$1,538	432%
Ucare Mn Senior Care Plus	$1,538	432%
Ucare Mn Special Needs Basic Care	$1,538	432%
Medicaid / KanCare	$1,540	432%
Medica Mcaid Mn Care	$1,563	439%
Ucare Individual And Family Plan-All Other Plans	$1,768	496%
Health Partners Minnesota Care	$2,136	599%
Medica Commercial-All Other Plans	$2,950	828%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$3,203	899%
Health Partners-All Plans	$3,502	983%
Preferred One (Ppo)	$3,630	1018%
Sanford Health Plan-All Plans	$3,630	1018%

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 $2,776.
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 Perham Health 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.