CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Ocean Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,014
Cash Discount Price: $374
vs. Medicare Baseline: 2.84x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Ocean Medical Center is $1,014. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.84x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$374

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,014

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: $374 (105%)

Insurance Median: $1,014 (284%)

Cash: $374 (105% of Medicare)

Ins. Median: $1,014 (284% 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 284% of the Medicare baseline (a markup of 184%). 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
Karna	$191 - $630	54%
Aetna	$357 - $5,145	100%
Amerigroup	$357	100%
Horizon	$357 - $4,649	100%
Vaccn	$357 - $390	100%
Wellcare	$357 - $390	100%
United Community/Americhoice	$375 - $410	105%
Blue Cross Blue Shield	$390	109%
UnitedHealthcare	$468 - $951	131%
Activecare First McO	$650 - $4,288	182%
Cigna	$686 - $704	192%
Oxford	$895	251%
Clover	$1,014	284%
Seoul Medical Group	$1,092 - $1,317	306%
Amerihealth	$1,532 - $1,558	430%
Qualcare	$2,083 - $4,735	584%
Brighton Health Plan	$3,885	1090%
Intergroup	$4,288	1203%
Bergen Risk	$4,332	1215%
Multiplan - PHCS	$4,786 - $5,206	1343%
Prime Health	$4,900	1375%

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 $374.
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 Ocean Medical Center 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.