CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Glens Falls Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $799
Cash Discount Price: $952
vs. Medicare Baseline: 2.24x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Glens Falls Hospital is $799. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $952. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.24x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$952

Average discount available for prompt cash payment at this facility.

Insurance Median

$799

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: $952 (267%)

Insurance Median: $799 (224%)

Cash: $952 (267% of Medicare)

Ins. Median: $799 (224% 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 224% of the Medicare baseline (a markup of 124%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$114 - $909	32%
Blue Shield	$322 - $1,044	90%
Cdphp	$330 - $1,798	93%
Mvp Commercial	$331 - $724	93%
Blue Cross Blue Shield	$421 - $1,237	118%
Mvp	$799 - $1,678	224%
Fidelis	$879 - $1,798	247%
Hamaspik	$1,237	347%
Nascentia Health Options	$1,237	347%
Magnacare	$1,427	400%
Emblem	$1,522	427%
Empire Plan Nyship	$1,618	454%
Multiplan	$1,618	454%
UnitedHealthcare	$1,618	454%

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 $952.
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 Glens Falls 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.