CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Mary's Healthcare

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $580
  • Cash Discount Price: $2,787
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Mary's Healthcare is $580. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,787. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.63x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$2,787

Average discount available for prompt cash payment at this facility.

Insurance Median
$580

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: $2,787 (782%)
Insurance Median: $580 (163%)
Cash: $2,787 (782% of Medicare)
Ins. Median: $580 (163% 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
Highmark_Hmo_Pos $427 120%
Medicare (plans) $435 - $488 122%
Tricare $435 122%
Va $435 122%
Blue Cross Blue Shield $449 - $1,873 126%
Aetna $457 - $3,034 128%
Humana $457 128%
Medicaid / KanCare $580 - $650 163%
UnitedHealthcare $580 163%
Cdphp_Commercial $587 165%
Carelon_Commercial $2,022 567%
Carelon_Empire $2,022 567%
Emblem_Commercial $2,832 795%
Excellus_Commercial $2,993 840%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals