CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $435
Cash Discount Price: $7,034
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St John's Episcopal Hospital at South Shore is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,034. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.22x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.

Cash / Self-Pay

$7,034

Average discount available for prompt cash payment at this facility.

Insurance Median

$435

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: $7,034 (1973%)

Insurance Median: $435 (122%)

Cash: $7,034 (1973% of Medicare)

Ins. Median: $435 (122% 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
UnitedHealthcare	$300 - $435	84%
Healthfirst	$361 - $980	101%
Vns	$414 - $435	116%
Aetna	$435 - $800	122%
Blue Cross Blue Shield	$435 - $654	122%
Centerlight	$435	122%
Centers Plan For Healthy Living	$435	122%
Elderplan	$435	122%
Emblem Health	$435	122%
Fidelis	$435	122%
Hamaspik	$435	122%
Humana	$435	122%
Longevity	$435	122%
Lucida	$435	122%
Metroplus	$435	122%
Village Care Max	$435	122%
Wellcare	$435	122%
Magnacare	$479	134%
Molina	$479	134%
Cigna	$1,248	350%
1199 National Benefit Fund	$1,268	356%

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 $7,034.
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 St John's Episcopal Hospital at South Shore 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.