CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,308
Cash Discount Price: $13,749
vs. Medicare Baseline: 3.67x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Southern Hills Hospital and Medical Center is $1,308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,749. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.67x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$13,749

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,308

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: $13,749 (3857%)

Insurance Median: $1,308 (367%)

Cash: $13,749 (3857% of Medicare)

Ins. Median: $1,308 (367% 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 367% of the Medicare baseline (a markup of 267%). 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	$107 - $415	30%
Ambetter / Centene	$125 - $2,887	35%
United	$267 - $2,997	75%
Sierra	$639	179%
Aetna	$1,308	367%
Cigna	$1,915	537%
Corvel	$2,762	775%
Olympus Medsave Usa	$2,907 - $10,312	816%
Select Health	$2,970 - $3,169	833%
Prominence Healthfirst	$4,125	1157%
Cmn Global	$5,775	1620%
Evernorth	$6,874	1929%
Nv Health & Welfare Trust	$8,249	2314%
Multiplan	$8,662 - $10,037	2430%
First Health	$9,074 - $10,999	2546%
Medcare International	$10,312	2893%

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 $13,749.
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 Hills Hospital and 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.