CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Ira Davenport Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,426
Cash Discount Price: $3,769
vs. Medicare Baseline: 9.61x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Ira Davenport Memorial Hospital is $3,426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,769. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.61x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$3,769

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,426

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: $3,769 (1057%)

Insurance Median: $3,426 (961%)

Cash: $3,769 (1057% of Medicare)

Ins. Median: $3,426 (961% 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 961% of the Medicare baseline (a markup of 861%). 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
Empire	$82 - $288	23%
Blue Cross Blue Shield	$374 - $18,900	105%
Fidelis	$374	105%
Humana	$423 - $5,607	119%
Tricare	$423	119%
Amerihealth Caritas Mcr Adv - All Plans	$427	120%
UnitedHealthcare	$2,315 - $6,541	649%
Fidelis Care - Exchange - All Plans	$3,426	961%
Geisinger - All Plans	$3,625	1017%
Cigna	$3,881	1089%
Mvp Health Plan - All Plans	$3,881	1089%
Independent Health - All Plans	$4,049	1136%
Upmc - All Plans	$4,299	1206%
Pomco Inc - All Plans	$4,485	1258%
Aetna	$4,672 - $5,560	1311%
Emblem Health - All Plans	$5,482	1538%
Emblem/Ghi	$5,756	1615%
Martins Point - All Plans	$6,230	1748%
Healthnow - All Plans	$20,520	5757%

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 $3,769.
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 Ira Davenport Memorial 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.