CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Garnet Health Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $555
  • Cash Discount Price: $813
  • vs. Medicare Baseline: 2.28x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Garnet Health Medical Center is $555. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $813. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.28x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.
Cash / Self-Pay
$813

Average discount available for prompt cash payment at this facility.

Insurance Median
$555

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $813 (334%)
Insurance Median: $555 (228%)
Cash: $813 (334% of Medicare)
Ins. Median: $555 (228% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $298 - $941 122%
Fidelis $304 125%
Wellcare $305 125%
Magnacare $369 - $590 151%
UnitedHealthcare $374 153%
Mvp $496 203%
Rojw $521 214%
Northwell Direct $611 251%
Emblem Health $681 279%
Geisinger Health Plan $745 306%
Local 1199 $941 386%
Blue Cross Blue Shield $2,006 - $2,934 823%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 East Main Street, Middletown, NY 10940
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals