CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Holmes County Hospital and Clinics

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,624
Cash Discount Price: $1,522
vs. Medicare Baseline: 7.36x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Holmes County Hospital and Clinics is $2,624. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,522. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.36x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.

Cash / Self-Pay

$1,522

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,624

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: $1,522 (427%)

Insurance Median: $2,624 (736%)

Cash: $1,522 (427% of Medicare)

Ins. Median: $2,624 (736% 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 736% of the Medicare baseline (a markup of 636%). 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
Ms-Can-Molina-Lex	$280	79%
Ms-Can-Magnolia-Lex	$283	79%
Ms-Can-Truecare-Lex	$286	80%
Molina-Chip-Lex	$599	168%
Magnolia-Chip-Lex	$612	172%
Truecare-Chip-Lex	$612	172%
Advhealth-Lex	$917	257%
Blue Cross Blue Shield	$1,343	377%
United-Lex	$1,390	390%
Cigna	$1,822	511%
United-Options-Lex	$1,875	526%
Tricare	$2,334	655%
Humana	$2,374	666%
Mpcn-Lex	$2,473	694%
Medadv_Uhc-Lex	$2,586	726%
Firstchoice-Lex	$2,663	747%
Ambetter / Centene	$2,853	800%
Medadv_Primewell-Lex	$2,853	800%
Medicare (plans)	$2,853	800%
Primewell-Lex	$2,853	800%
Va_Ccn-Lex	$2,853	800%
Medadv_Uhcdsnp-Lex	$2,939	825%
Wellcare-Lex	$2,939	825%
Ppoplus	$2,967	832%
Devoted_Health-Lex	$2,996	841%
Firsthealth-Lex	$3,043	854%
Multiplan-Lex	$3,043	854%
Aetna	$3,233	907%
Phcs-Lex	$3,424	961%
Molina_Exchange-Lex	$3,804	1067%

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 $1,522.
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 Holmes County Hospital and Clinics 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.