CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Children's Nebraska

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,217
Cash Discount Price: Unavailable
vs. Medicare Baseline: 6.22x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Children's Nebraska is $2,217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.22x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,217

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%)

Insurance Median: $2,217 (622%)

Ins. Median: $2,217 (622% 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 622% of the Medicare baseline (a markup of 522%). 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
Medicaid / KanCare	$437 - $2,217	123%
Wellpoint	$437	123%
Molina (Iowa)	$453	127%
Ambetter / Centene	$713	200%
Molina (Nebraska)	$884	248%
UnitedHealthcare	$960 - $1,067	269%
Midlands Choice Chi	$5,006	1404%
Blue Cross Blue Shield	$5,149 - $5,722	1445%
Midlands Choice Elevate	$5,722	1605%
Avera Health Plan	$6,079	1706%
Centivo	$6,079	1706%
Wellmark	$6,079	1706%
Aetna	$6,294	1766%
Midlands Choice	$6,294	1766%
Sanford Health Plan	$6,294	1766%

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 $X.
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 Children's Nebraska 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.