CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Sanford Medical Center Fargo

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,614
Cash Discount Price: $4,347
vs. Medicare Baseline: 7.33x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Sanford Medical Center Fargo is $2,614. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,347. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.33x the Medicare baseline. Located in 801 Broadway North, Fargo, ND.

Cash / Self-Pay

$4,347

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,614

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: $4,347 (1220%)

Insurance Median: $2,614 (733%)

Cash: $4,347 (1220% of Medicare)

Ins. Median: $2,614 (733% 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 733% of the Medicare baseline (a markup of 633%). 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
Blue Cross Blue Shield	$280 - $679	79%
Sanford Health Plan	$327	92%
Sanford Health Plan Align	$339	95%
Ucare	$364 - $3,820	102%
Aetna	$368 - $4,646	103%
Health Partners	$368 - $2,228	103%
Medicare (plans)	$368	103%
UnitedHealthcare	$368 - $4,733	103%
Primewest	$375 - $403	105%
Medica	$2,445 - $2,614	686%
Security Health Plan	$2,989	839%
Cigna	$4,891	1372%
First Choice Health Network	$4,891	1372%
Healthez	$4,891	1372%
Multiplan	$4,891	1372%

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 $4,347.
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 Sanford Medical Center Fargo 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.