CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Highland Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $558
Cash Discount Price: $2,680
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Highland Hospital is $558. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,680. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.57x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$2,680

Average discount available for prompt cash payment at this facility.

Insurance Median

$558

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: $2,680 (752%)

Insurance Median: $558 (157%)

Cash: $2,680 (752% of Medicare)

Ins. Median: $558 (157% 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.

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
Medicaid / KanCare	$262 - $1,136	74%
Aetna	$301 - $992	84%
Elderplan [1316]	$301	84%
Excellus Bc/Bs [2201]	$301 - $568	84%
Icircle [1728]	$301	84%
Martins Point [1205]	$301 - $435	84%
Medicare (plans)	$301 - $585	84%
Nascentia [1729]	$301	84%
UnitedHealthcare	$301 - $871	84%
Humana	$304 - $541	85%
Highmark Bc/Bs Of Western Ny [5143]	$434	122%
Blue Cross Blue Shield	$435 - $621	122%
Amerigroup (Bswny Alternate) [1720]	$505	142%
Excellus [2201]	$505 - $820	142%
Molina Healthcare [5189], Molina Healthcare [1723]	$505	142%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$545 - $1,056	153%
Mvp [2900]	$558 - $1,497	157%
Independent Health [5156]	$579 - $700	162%
Cigna	$730 - $1,497	205%
Capital District Physicians Health Plan (Cdphp) [5149]	$816 - $1,092	229%
Fidelis [5155]	$1,111 - $1,189	312%

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 $2,680.
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 Highland Hospital 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.