CMS Price Transparency Data

MRI, brain (no contrast)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $298
Cash Discount Price: $3,300
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at St John's Episcopal Hospital at South Shore is $298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,300. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.22x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.

Cash / Self-Pay

$3,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$298

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: $3,300 (1354%)

Insurance Median: $298 (122%)

Cash: $3,300 (1354% of Medicare)

Ins. Median: $298 (122% 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
Healthfirst	$247 - $372	101%
Vns	$283 - $298	116%
Aetna	$298 - $800	122%
Blue Cross Blue Shield	$298 - $447	122%
Centerlight	$298	122%
Centers Plan For Healthy Living	$298	122%
Elderplan	$298	122%
Emblem Health	$298	122%
Fidelis	$298	122%
Hamaspik	$298	122%
Humana	$298	122%
Longevity	$298	122%
Lucida	$298	122%
Metroplus	$298	122%
UnitedHealthcare	$298 - $300	122%
Village Care Max	$298	122%
Wellcare	$298	122%
Magnacare	$328	135%
Molina	$328	135%
1199 National Benefit Fund	$571	234%
Cigna	$1,248	512%

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 $3,300.
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 St John's Episcopal Hospital at South Shore 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.