CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Southern Ocean Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,098
Cash Discount Price: $390
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Southern Ocean Medical Center is $1,098. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.08x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$390

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,098

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: $390 (109%)

Insurance Median: $1,098 (308%)

Cash: $390 (109% of Medicare)

Ins. Median: $1,098 (308% 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 308% of the Medicare baseline (a markup of 208%). 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 - $600	54%
Blue Cross Blue Shield	$390	109%
Wellcare	$390	109%
Vaccn	$390	109%
United Community/Americhoice	$410	115%
Aetna	$425 - $4,409	119%
UnitedHealthcare	$468 - $951	131%
Cigna	$686 - $4,505	192%
Oxford	$895 - $3,046	251%
Clover	$1,014	284%
Seoul Medical Group	$1,154	324%
Amerihealth	$1,532 - $1,558	430%
Horizon	$3,666 - $5,148	1029%
Brighton Health Plan	$3,885	1090%
Bergen Risk	$4,332	1215%
Multiplan - PHCS	$4,786	1343%
Qualcare	$5,113	1435%

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 $390.
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 Southern 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.