CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Saratoga Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $81
Cash Discount Price: $1,856
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Saratoga Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,856. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.33x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$1,856

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $1,856 (761%)

Insurance Median: $81 (33%)

Cash: $1,856 (761% of Medicare)

Ins. Median: $81 (33% 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.

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
Cdphp	$45 - $1,193	18%
Blue Cross Blue Shield	$49 - $3,317	20%
Fidelis	$49 - $1,193	20%
Medicare (plans)	$49 - $66	20%
Tricare	$56 - $66	23%
Hamaspik	$62 - $1,246	25%
Medicaid / KanCare	$62	25%
Emblem Health Ghi	$66 - $72	27%
UnitedHealthcare	$66 - $4,265	27%
Aetna	$67 - $2,322	27%
Mvp	$67 - $126	27%
Blue Shield Highmark	$75 - $94	31%
Cigna	$104 - $126	43%
Blue Shield	$260 - $775	107%
Nascentia Health Options	$280	115%
Emblem	$286 - $287	117%
Mvp Essential Plan	$530 - $1,061	217%
Mvp Govt Programs	$530	217%
Mvp Commercial	$1,379 - $3,317	566%
Empire Plan Nyship	$2,598 - $3,317	1066%
Multiplan	$2,784 - $4,028	1142%
Magnacare	$3,341 - $4,502	1371%

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 $1,856.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Saratoga Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.