CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Little Falls Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $479
Cash Discount Price: $679
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Little Falls Hospital is $479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $679. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.34x the Medicare baseline. Located in 140 Burwell Street, Little Falls, NY.

Cash / Self-Pay

$679

Average discount available for prompt cash payment at this facility.

Insurance Median

$479

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: $679 (191%)

Insurance Median: $479 (134%)

Cash: $679 (191% of Medicare)

Ins. Median: $479 (134% 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
Emblem	$147 - $1,260	41%
UnitedHealthcare	$147 - $1,260	41%
Cdphp	$152 - $1,298	43%
Mvp	$152 - $1,298	43%
Blue Cross Blue Shield	$154 - $5,207	43%
Aetna	$157 - $1,485	44%
Fidelis	$157 - $1,348	44%
Humana	$159 - $1,361	45%
Cigna	$447 - $4,759	125%

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 $679.
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 Little Falls 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.