CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Gillette Childrens Specialty Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,381
Cash Discount Price: $3,381
vs. Medicare Baseline: 9.49x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Gillette Childrens Specialty Hospital is $3,381. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,381. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.49x the Medicare baseline. Located in 200 University Avenue East, Saint Paul, MN.

Cash / Self-Pay

$3,381

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,381

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: $3,381 (949%)

Insurance Median: $3,381 (949%)

Cash: $3,381 (949% of Medicare)

Ins. Median: $3,381 (949% 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 949% of the Medicare baseline (a markup of 849%). 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
Ucare	$78 - $4,156	22%
Blue Cross Blue Shield	$130 - $7,327	36%
Health Partners	$160 - $7,532	45%
UnitedHealthcare	$180 - $6,213	51%
Medica	$195 - $7,688	55%
Humana	$284 - $6,233	80%
Aetna	$356 - $7,792	100%
America'S Ppo	$379 - $8,311	106%
Geha	$403 - $8,831	113%
Multiplan	$403 - $8,831	113%

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 $3,381.
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 Gillette Childrens Specialty 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.