CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Sanford Hillsboro

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,847
Cash Discount Price: $3,730
vs. Medicare Baseline: 10.79x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Sanford Hillsboro is $3,847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,730. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.79x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$3,730

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,847

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: $3,730 (1046%)

Insurance Median: $3,847 (1079%)

Cash: $3,730 (1046% of Medicare)

Ins. Median: $3,847 (1079% 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 1079% of the Medicare baseline (a markup of 979%). 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	$608 - $3,027	171%
Sanford Health Plan Align	$2,126	596%
Ucare	$2,285 - $4,097	641%
Aetna	$2,304 - $4,052	646%
Health Partners	$2,304 - $3,637	646%
Medicare (plans)	$2,304	646%
UnitedHealthcare	$2,304 - $3,894	646%
Primewest	$2,350	659%
Security Health Plan	$2,565	720%
Sanford Health Plan	$3,681 - $4,331	1033%
Medica	$3,847 - $4,113	1079%
First Choice Health Network	$4,197	1178%
Healthez	$4,197	1178%
Multiplan	$4,197	1178%

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 $3,730.
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 Hillsboro 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.