CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Essentia Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,868
  • Cash Discount Price: $3,113
  • vs. Medicare Baseline: 5.24x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Essentia Health is $1,868. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,113. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.24x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$3,113

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,868

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: $3,113 (873%)
Insurance Median: $1,868 (524%)
Cash: $3,113 (873% of Medicare)
Ins. Median: $1,868 (524% 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 524% of the Medicare baseline (a markup of 424%). 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
Advocare/Security Health $357 100%
Blue Cross Blue Shield $357 - $2,801 100%
Freedom Blue Ppo $357 100%
Healthpartners Care Msho / Mcr Adv $357 100%
Imcare Msho Pcc Prime $357 100%
Imcare Msho Ref Req $357 100%
Itasca Med Care $357 100%
Medica Advantage Solutions $357 100%
Medica Msho/Dual Solutions $357 100%
Medica Prime Solution Group $357 100%
Medicare (plans) $357 100%
Nd Va Administration $357 100%
Platinum Blue/Vantage Blue $357 100%
Primewest Msho $357 100%
Secure Blue Msho $357 100%
Ubh Cost Plan $357 100%
Ubh Msho $357 100%
Ucare Msho $357 100%
UnitedHealthcare $357 - $3,308 100%
Primewest $371 104%
Sanford Health Plan $632 - $1,874 177%
Medica Access $1,112 312%
Healthpartners Care Pmap $1,614 453%
Medica $2,299 - $2,556 645%
Medica Uplan $2,299 645%
Medica Choice $2,631 738%
Ucare $2,731 766%
Cigna $2,780 780%
Healthpartners $2,780 780%
Healthpartners Pcc Prime $2,780 780%
Wea $2,988 - $3,196 838%
America'S Ppo $3,216 902%
Wps $3,444 - $3,486 966%
Aetna $3,528 990%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals