CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Salem Memorial District Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,339
  • Cash Discount Price: $3,130
  • vs. Medicare Baseline: 9.37x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Salem Memorial District Hospital is $3,339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,130. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.37x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$3,130

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,339

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: $3,130 (878%)
Insurance Median: $3,339 (937%)
Cash: $3,130 (878% of Medicare)
Ins. Median: $3,339 (937% 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 937% of the Medicare baseline (a markup of 837%). 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
Aetna $1,419 - $3,756 398%
Ambetter / Centene $1,419 398%
Blue Cross Blue Shield $1,419 - $3,965 398%
Humana $1,419 - $3,548 398%
Tricare $1,419 398%
Triwest $1,419 398%
UnitedHealthcare $1,419 398%
Veteran'S Affairs $1,419 398%
Healthlink $2,713 761%
First Health $3,339 937%
Mercy - C.B. Management Company/Joplin Supply Company $3,339 937%
Mercy - City Of Springfield $3,339 937%
Mercy - Clayco $3,339 937%
Mercy - Commerce Bank $3,339 937%
Mercy - Diversified Plastics $3,339 937%
Mercy - Employers Benefit Alliance $3,339 937%
Mercy - Evolutions $3,339 937%
Mercy - Fabick Cat $3,339 937%
Mercy - Firsthealth Network $3,339 937%
Mercy - Health Management Network $3,339 937%
Mercy - Health Systems Inc $3,339 937%
Mercy - Liberty Utilities/Empire District Electric $3,339 937%
Mercy - Life Church $3,339 937%
Mercy - Missouri State University $3,339 937%
Mercy - Prime Health Services $3,339 937%
Mercy - Quiktrip Corporation $3,339 937%
Mercy - Shinesolar $3,339 937%
Mercy - Springfield Public Schools $3,339 937%
Mercy - Springfield Remanufacturing $3,339 937%
Mercy - Sumnerone $3,339 937%
Mercy - Trailiner $3,339 937%
Mercy - Walmart Mercy Accountable Care Plan $3,339 937%
Mercy-American Healthcare Alliance $3,339 937%
Phcs $3,339 - $3,548 937%
Cigna $3,544 994%
Mercy - Compresults $3,756 1054%
Mercy - Corvel Corporation $3,756 1054%
Mercy - Novasys $3,756 1054%
Mercy - Scurlock Industries $3,756 1054%
Mercy - Usa Managed Care Organization $3,756 1054%
Right Choice-Alliance $3,965 1112%
Right Choice-Regular $4,049 1136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals