CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Kaleida Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $345
  • Cash Discount Price: $1,896
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Kaleida Health is $345. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,896. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.97x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
$1,896

Average discount available for prompt cash payment at this facility.

Insurance Median
$345

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: $1,896 (532%)
Insurance Median: $345 (97%)
Cash: $1,896 (532% of Medicare)
Ins. Median: $345 (97% 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.

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
Fidelis Care $57 - $179 16%
Univera Healthcare $89 - $276 25%
Molina Healthcare Of New York, Inc. $90 - $214 25%
Highmark Wny $95 - $138 27%
Humana $100 28%
UnitedHealthcare $100 - $473 28%
American Progressive Life & Health $103 29%
Meritain Health $164 46%
Ghi/Emblem Health $238 - $588 67%
Ghi/Emblem Health - Wchob $238 - $298 67%
Aetna $248 - $462 70%
Magnacare $248 - $317 70%
Magnacare - Wchob $248 - $317 70%
Independent Health Association $253 - $870 71%
Independent Health Association - Wchob $263 - $870 74%
Blue Cross Blue Shield $297 - $1,625 83%
Tricare $414 116%
Univera $427 - $2,502 120%
Wellcare $453 127%
Fidelis $470 132%
Cigna $510 - $618 143%
Univera - Wchob $590 - $2,502 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals