CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Spring Valley Hospital Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,452
Cash Discount Price: $4,932
vs. Medicare Baseline: 4.07x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Spring Valley Hospital Medical Center is $1,452. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,932. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.07x the Medicare baseline. Located in 5400 South Rainbow Blvd, Las Vegas, NV.

Cash / Self-Pay

$4,932

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,452

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: $4,932 (1384%)

Insurance Median: $1,452 (407%)

Cash: $4,932 (1384% of Medicare)

Ins. Median: $1,452 (407% 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 407% of the Medicare baseline (a markup of 307%). 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
Blue Cross Blue Shield	$415 - $621	116%
Smart_Choice	$415	116%
Silver_Summit	$423	119%
Molina	$427	120%
Cigna	$525 - $753	147%
United_Healthcare	$859	241%
Humana	$1,202	337%
Prominence	$1,452 - $2,355	407%
Sierra_Health_Options	$1,967 - $2,792	552%
Aetna	$1,980 - $4,556	556%
Sierra_Health_Plan_Of_Nevada	$3,272 - $4,643	918%
Multiplan	$5,913 - $8,390	1659%

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 $4,932.
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 Spring Valley Hospital 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.