CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Louis Childrens Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $5,527
  • Cash Discount Price: $4,651
  • vs. Medicare Baseline: 15.51x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Louis Childrens Hospital is $5,527. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,651. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 15.51x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.
Cash / Self-Pay
$4,651

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,527

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: $4,651 (1305%)
Insurance Median: $5,527 (1551%)
Cash: $4,651 (1305% of Medicare)
Ins. Median: $5,527 (1551% 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 1551% of the Medicare baseline (a markup of 1451%). 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 $343 - $6,124 96%
Blue Cross Blue Shield $343 - $6,589 96%
Essence Healthcare [221] $343 96%
Humana $343 - $5,775 96%
UnitedHealthcare $343 - $5,760 96%
Cox Health [757] $361 101%
Medica [662] $361 101%
Health Alliance [224] $3,550 996%
Healthlink [225] $3,760 - $5,853 1055%
Cigna $3,829 - $4,209 1074%
Consociate [478] $4,202 1179%
Sarah Bush Lincoln [636] $4,202 1179%
Apwu Health Plan [216] $4,209 1181%
Nalc Health Benefit Plan [242] $4,209 1181%
Priority Health [648] $4,209 1181%
Cox Health Systems Insurance Company [220] $4,264 - $5,736 1196%
Allied Benefits [498] $4,496 - $6,124 1261%
Hope Trust [806] $4,496 1261%
Healthscope Benefits [258] $4,729 - $6,202 1327%
Med-Pay [480] $5,039 - $5,814 1414%
Unicare [568] $5,039 - $5,853 1414%
First Health Commercial [734] $5,760 1616%
Beechstreet [551] $5,814 1631%
Detego Health [868] $5,814 1631%
Health Systems Inc [620] $5,814 1631%
Healthcare Sol Mercy [609] $5,814 1631%
Multiplan Commercial [737] $5,814 1631%
Multiplan [240] $5,814 1631%
Phcs [244] $5,814 - $6,202 1631%
Preferred Health Professionals [561] $5,853 1642%
Coresource [497] $6,124 1718%
Fmh Benefit Service Inc [222] $6,124 1718%
Mail Handlers [495] $6,124 1718%
Medica [661] $6,202 1740%
Hfn [563] $6,589 1849%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Childrens Place, Saint Louis, MO 63110
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens