CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Francis Hospital - the Heart Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $828
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Francis Hospital - the Heart Center is $828. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.32x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$828

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%)
Insurance Median: $828 (232%)
Ins. Median: $828 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Blue Cross Blue Shield $414 - $970 116%
Aetna $423 - $3,499 119%
Centerlight Healthcare $423 - $505 119%
Centers Plan For Healthy Living $423 119%
Elderplan Inc. $423 - $505 119%
Emblem Health $423 - $951 119%
Fidelis Care New York $423 - $1,136 119%
Health Plus $423 - $1,136 119%
Healthspring $423 119%
Independent Health $423 - $505 119%
Liberty Health $423 119%
Longevity Health Plan $423 119%
Medicare (plans) $423 - $444 119%
Mvp Health Plans $423 - $2,174 119%
Orthonet - Uniformed Services Family Health Plan $423 119%
Pmc $423 119%
Senior Whole Health $423 - $505 119%
Tricare $423 119%
UnitedHealthcare $423 - $1,136 119%
Universal Healthcare $423 119%
Us Family Health Plan $423 119%
Veterans Affairs $423 119%
Health First $427 - $1,136 120%
Humana $431 121%
Agewell New York $437 123%
Partners Health Plan $444 125%
Wellcare Health Plan Inc $465 130%
Affinity Health Plan $505 - $1,136 142%
Medicaid / KanCare $505 142%
Zadroga $637 179%
Brighton $827 - $3,396 232%
Surest $828 232%
American Plan Administrators $951 267%
Amerihealth Administrators $951 267%
Benefit Services $951 267%
Ghi Cbp Ny City Employee Alternate $951 267%
International Benefit Administrator $951 267%
Ultra Benefits Inc. $951 267%
Self Pay $970 272%
Apwu $2,174 610%
Centivo $2,174 - $2,694 610%
Cigna $2,174 - $6,300 610%
Daniel H Cook $2,174 610%
Nalc $2,174 610%
Samba $2,174 610%
Mail Handlers Benefit Plan $3,499 982%
Meritain Health $3,499 982%
Nippon Life Insurance Company Of America $3,499 982%
Salvation Army $3,499 982%
Oscar Health $3,690 1035%
Local 1199 $5,072 1423%
Allied Wellfare Fund $6,300 1768%
American Group Administrators $6,300 1768%
Bakery & Confectionery Union $6,300 1768%
Comprehensive Benefits Consultant $6,300 1768%
Guardian Life Insurance Company Of America $6,300 1768%
Maloney And Assoc $6,300 1768%
Multiplan $6,300 1768%
Performax $6,300 1768%
Phcs $6,300 1768%
Pomco $6,300 1768%
Tpa Inc $6,300 1768%
Unicare $6,300 1768%
United Employees Health Plan $6,300 1768%
Coventry $6,660 - $7,470 1869%
Galaxy $8,100 2273%
Three Rivers Provider Network $8,100 2273%
Aither Health $9,000 2525%
Alpha Care $9,000 2525%
Dentaquest $9,000 2525%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals