CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Robert Wood Johnson University Hospital at Hamilton

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $613
Cash Discount Price: $826
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Robert Wood Johnson University Hospital at Hamilton is $613. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $826. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.72x the Medicare baseline. Located in One Hamilton Health Place, Hamilton, NJ.

Cash / Self-Pay

$826

Average discount available for prompt cash payment at this facility.

Insurance Median

$613

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: $826 (232%)

Insurance Median: $613 (172%)

Cash: $826 (232% of Medicare)

Ins. Median: $613 (172% 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.

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
Cigna	$327 - $437	92%
Aetna	$390 - $671	109%
Blue Cross Blue Shield	$390 - $4,282	109%
Clover Health	$390	109%
Fidelis Care	$390 - $630	109%
Humana	$390	109%
Wellpoint	$390	109%
UnitedHealthcare	$398 - $613	112%
Emblem Health	$683	192%
Wellcare	$777	218%
Amerihealth	$1,002 - $1,077	281%
First Health	$3,023	848%
Qualcare Inc	$3,493	980%

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 $826.
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 Robert Wood Johnson University Hospital at Hamilton 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.