CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Elizabethtown Community Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $300
Cash Discount Price: $2,645
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Elizabethtown Community Hospital is $300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,645. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.23x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$2,645

Average discount available for prompt cash payment at this facility.

Insurance Median

$300

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: $2,645 (1085%)

Insurance Median: $300 (123%)

Cash: $2,645 (1085% of Medicare)

Ins. Median: $300 (123% 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
Capital District Physicians' Health Plan	$126 - $4,178	52%
UnitedHealthcare	$130 - $4,681	53%
Fidelis Care	$158 - $1,932	65%
Harvard Pilgrim	$165 - $4,066	68%
Magnacare	$165 - $4,066	68%
Blue Cross Blue Shield	$167 - $3,820	69%
Coventry	$175 - $4,321	72%
Humana	$176 - $230	72%
Aetna	$185 - $3,812	76%
Martins Point	$185 - $1,932	76%
Multiplan	$185 - $4,575	76%
Mvp	$185 - $3,970	76%
Veterans Affairs Community Care Network	$185 - $1,932	76%
Choicecare	$204 - $4,066	84%
Wellpath	$260 - $2,897	107%
Highmark Blueshield	$271 - $4,143	111%
Emblem Health	$4,066	1668%

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 $2,645.
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 Elizabethtown Community 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.