CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Jfk University Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,196
Cash Discount Price: $376
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Jfk University Medical Center is $1,196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $376. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.36x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$376

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,196

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: $376 (105%)

Insurance Median: $1,196 (336%)

Cash: $376 (105% of Medicare)

Ins. Median: $1,196 (336% 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 336% of the Medicare baseline (a markup of 236%). 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	$196 - $630	55%
Vaccn	$357 - $396	100%
Aetna	$357 - $5,145	100%
Amerigroup	$357 - $396	100%
Wellcare	$357 - $396	100%
Horizon	$357 - $5,692	100%
United Community/Americhoice	$375 - $415	105%
Blue Cross Blue Shield	$396	111%
Cigna	$704	198%
Oxford	$951	267%
UnitedHealthcare	$951 - $1,053	267%
Clover	$1,102	309%
Seoul Medical Group	$1,317	369%
Amerihealth	$1,370 - $1,516	384%
Brighton Health Plan	$4,226	1186%
Intergroup	$4,288	1203%
Activecare First McO	$4,288	1203%
Bergen Risk	$4,332	1215%
Qualcare	$4,735 - $4,961	1328%
Prime Health	$4,900	1375%
Multiplan - PHCS	$5,206	1461%

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 $376.
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 Jfk University 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.