CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $775
  • Cash Discount Price: $1,420
  • vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mary Hitchcock Memorial Hospital is $775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,420. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.17x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.
Cash / Self-Pay
$1,420

Average discount available for prompt cash payment at this facility.

Insurance Median
$775

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: $1,420 (398%)
Insurance Median: $775 (217%)
Cash: $1,420 (398% of Medicare)
Ins. Median: $775 (217% 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 217% of the Medicare baseline (a markup of 117%). 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
Wellsense Health Plan $62 - $916 17%
Beacon Health Strategies/Carelon $83 - $916 23%
Amerihealth Caritas Nh $86 - $850 24%
Granite State Health Plan $86 - $944 24%
Blue Cross Blue Shield $105 - $6,535 29%
Martin'S Point Generations Advantage $105 - $400 29%
Mvp $105 - $5,024 29%
UnitedHealthcare $105 - $5,759 29%
Martin'S Point Health Care $107 - $2,587 30%
Aetna $108 - $5,264 30%
Cigna $108 - $5,144 30%
Wellcare Health Plans $109 - $416 31%
Ambetter / Centene $111 - $860 31%
Harvard Pilgrim Health Care Of Ne $132 - $4,811 37%
Mass General Brigham Health Plan $305 - $4,664 86%
Tufts Health Plan $350 - $4,375 98%
Maine Community Health Options $1,134 - $5,512 318%
Coventry $1,549 - $6,524 435%
First Health/Hcvm $1,549 - $6,524 435%
Phcs $1,602 - $6,749 449%
Corvel $1,638 - $6,899 460%
Ccmsi $1,691 - $7,124 474%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Medical Center Drive, Lebanon, NH 03756
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals