CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: S E Lackey Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $700
Cash Discount Price: $1,687
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at S E Lackey Memorial Hospital is $700. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,687. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.96x the Medicare baseline. Located in 330 N Broad Street, Forest, MS.

Cash / Self-Pay

$1,687

Average discount available for prompt cash payment at this facility.

Insurance Median

$700

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: $1,687 (473%)

Insurance Median: $700 (196%)

Cash: $1,687 (473% of Medicare)

Ins. Median: $700 (196% 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.

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
Cigna	$50 - $700	14%
UnitedHealthcare	$70 - $1,273	20%
Magnolia Mcr Adv	$85 - $1,072	24%
Blue Cross Blue Shield	$100 - $1,914	28%
Va Ccn - All Plans	$100 - $1,072	28%
Wellcare Mcr Adv - All Plans	$100 - $1,072	28%
Magnolia Mcaid	$272 - $306	76%
Corvel - All Plans	$740 - $2,297	208%
Magnolia Comm/Exch - All Other Plans	$1,072	301%
First/Health Choice - All Plans	$2,042	573%
Health Partners - All Plans	$2,118	594%
Multiplan - All Plans	$2,297	644%

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 $1,687.
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 S E Lackey Memorial 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.