CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Mount Carmel East & West
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $1,453
- Cash Discount Price: $2,022
- vs. Medicare Baseline: 4.08x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mount Carmel East & West is $1,453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,022. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.08x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$2,022
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,453
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: $2,022 (567%)
Insurance Median: $1,453 (408%)
Cash: $2,022 (567% of Medicare)
Ins. Median: $1,453 (408% 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 408% of the Medicare baseline (a markup of 308%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $290 - $347 | 81% |
| Aetna | $323 - $3,111 | 91% |
| Blue Cross Blue Shield | $323 - $3,111 | 91% |
| Hospice Mount Carmel | $330 | 93% |
| Oscar | $330 | 93% |
| UnitedHealthcare | $330 - $1,904 | 93% |
| The Health Plan | $337 - $2,044 | 95% |
| Crime Victim Assistance | $632 | 177% |
| Ohio Safe Program | $632 | 177% |
| Enterprise Group Planning | $637 | 179% |
| Custom Design Benefits | $690 | 194% |
| Quality Care Partners | $746 | 209% |
| Medical Mutual | $827 - $2,367 | 232% |
| Western & Southern Financial Group | $1,148 | 322% |
| Blue Benefit Administrators Of Massachusetts | $1,255 | 352% |
| Blue Care Network | $1,255 | 352% |
| Blue Distinction Transplant | $1,255 | 352% |
| Blue Shield - Ca | $1,255 | 352% |
| Blue Shield - Id (Regence) | $1,255 | 352% |
| Blue Shield - Ny Highmark Northeastern | $1,255 | 352% |
| Blue Shield - Ny Highmark Western | $1,255 | 352% |
| Blue Shield - Pa (Highmark) | $1,255 | 352% |
| Blue Shield - Wa (Regence) | $1,255 | 352% |
| Geha | $1,397 - $1,904 | 392% |
| Gravie Admin Services | $1,397 | 392% |
| Healthez | $1,397 | 392% |
| Meritain | $1,397 | 392% |
| Webtpa | $1,397 | 392% |
| Access Health | $1,453 | 408% |
| Acclaim | $1,453 | 408% |
| Administrative Concepts | $1,453 | 408% |
| Allegeant | $1,453 | 408% |
| Allied Benefit Systems | $1,453 | 408% |
| American Family | $1,453 | 408% |
| American Healthcare Alliance | $1,453 | 408% |
| American National | $1,453 | 408% |
| American Republic | $1,453 | 408% |
| Amerihealth | $1,453 | 408% |
| Aultcare | $1,453 | 408% |
| Automated Benefit Services | $1,453 | 408% |
| Auxiant | $1,453 | 408% |
| Benefit Administrative Systems,Llc | $1,453 | 408% |
| Boon Chapman | $1,453 | 408% |
| Cam Administrative Services | $1,453 | 408% |
| Christian Brother Services | $1,453 | 408% |
| Christian Brothers Holy Cross | $1,453 | 408% |
| Claimchoice Adminstrators | $1,453 | 408% |
| Comprehensive Benefits | $1,453 | 408% |
| Continental Life Insurance | $1,453 | 408% |
| Coventry | $1,453 | 408% |
| Custom Benefit Administrators | $1,453 | 408% |
| Cypress Benefit Administrators | $1,453 | 408% |
| Employee Benefit Concepts | $1,453 | 408% |
| Employee Benefit Management | $1,453 | 408% |
| Forest County Potawatomi | $1,453 | 408% |
| Freedom Life Insurance Company | $1,453 | 408% |
| Group Administrators | $1,453 | 408% |
| Group Marketing Services | $1,453 | 408% |
| Group Pension Administrators | $1,453 | 408% |
| Guardian | $1,453 | 408% |
| Health America | $1,453 | 408% |
| Health Choices | $1,453 | 408% |
| Healthcare Management Admin | $1,453 | 408% |
| Insight | $1,453 | 408% |
| Intercare | $1,453 | 408% |
| Jfp Benefit Management | $1,453 | 408% |
| Jp Farley Corporation | $1,453 | 408% |
| Key Benefit Administrator | $1,453 | 408% |
| Liberty Union Life Assurance Co | $1,453 | 408% |
| Lucent Health | $1,453 | 408% |
| Luminare Health | $1,453 | 408% |
| Magnacare | $1,453 | 408% |
| Medcost | $1,453 | 408% |
| Mutual Health Services | $1,453 | 408% |
| Mutual Of Omaha | $1,453 | 408% |
| Ncas | $1,453 | 408% |
| Nippon Life Ins | $1,453 | 408% |
| Nova | $1,453 | 408% |
| Painters Union Insurance Fund | $1,453 | 408% |
| Physicians Mutual | $1,453 | 408% |
| Plumbers Local 98 Insurance Fund | $1,453 | 408% |
| Prairie States | $1,453 | 408% |
| Preferred One | $1,453 | 408% |
| Primary Physician Care | $1,453 | 408% |
| Professional Benefit Administrators | $1,453 | 408% |
| Secureone Preferred United Plans | $1,453 | 408% |
| Siho Insurance Services | $1,453 | 408% |
| Sisco Benefits | $1,453 | 408% |
| The Loomis Company | $1,453 | 408% |
| Trustmark Small Business Benefits | $1,453 | 408% |
| U Of M Health Plan | $1,453 | 408% |
| Unicare | $1,453 | 408% |
| Unified Group Services | $1,453 | 408% |
| Us Health And Life | $1,453 | 408% |
| Valenz | $1,453 | 408% |
| Varipro | $1,453 | 408% |
| Wps | $1,453 | 408% |
| Humana | $1,591 - $3,111 | 446% |
| First Health | $1,640 | 460% |
| Rural Carrier Health Benefit Plan | $1,776 | 498% |
| Medben | $1,867 - $2,333 | 524% |
| American Postal Workers Secondary | $1,875 | 526% |
| Cigna | $1,875 | 526% |
| Health Partners | $1,875 | 526% |
| Healthgram | $1,875 | 526% |
| Mvp | $1,875 | 526% |
| Priority Health | $1,875 | 526% |
| Consociate | $1,901 | 533% |
| Health Ohio Network | $1,901 | 533% |
| Caresource | $2,271 | 637% |
| Healthlink Inc | $2,333 | 655% |
| Medical Benefits Mutual | $2,333 | 655% |
| Ohio Health Choice | $2,333 | 655% |
| Ohio Ppo Connect | $2,333 | 655% |
| Medi Share | $2,486 | 697% |
| Multiplan | $2,486 | 697% |
| Phcs | $2,486 | 697% |
| Philadelphia American Life Insurance | $2,486 | 697% |
| Ameriben | $2,489 | 698% |
| Luminare Health (Detroit) | $2,489 | 698% |
| Ohiohealthy | $2,489 | 698% |
| Osu Not Independent Choice | $2,489 | 698% |
| Twin Valley Psychiatric | $2,489 | 698% |
| Health Smart | $2,644 | 742% |
| Bccp | $3,111 | 873% |
| Medicaid / KanCare | $3,111 | 873% |
| Optima Health | $3,111 | 873% |