CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: The University of Vermont Health Network - Champl

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $229
Cash Discount Price: $4,150
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at The University of Vermont Health Network - Champl is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,150. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.64x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.

Cash / Self-Pay

$4,150

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

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: $4,150 (1164%)

Insurance Median: $229 (64%)

Cash: $4,150 (1164% of Medicare)

Ins. Median: $229 (64% 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
Blue Cross Blue Shield	$53 - $5,149	15%
UnitedHealthcare	$72 - $6,139	20%
Aetna	$102 - $5,737	29%
Capital District Physicians' Health Plan	$102 - $6,343	29%
Fidelis Care	$102 - $436	29%
Humana	$102 - $415	29%
Martins Point	$102 - $467	29%
Veterans Affairs Community Care Network	$102 - $436	29%
Mvp	$138 - $6,404	39%
Highmark Blueshield	$140 - $6,356	39%
Wellpath	$143 - $655	40%
Harvard Pilgrim	$203 - $6,437	57%
Magnacare	$203 - $6,437	57%
St. Regis	$203 - $436	57%
Coventry	$229 - $7,241	64%
Multiplan	$241 - $7,644	68%
Emblem Health	$6,437	1806%

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 $4,150.
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 The University of Vermont Health Network - Champl 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.