CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Fairfield Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,188
Cash Discount Price: $1,469
vs. Medicare Baseline: 6.14x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Fairfield Medical Center is $2,188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,469. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.14x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$1,469

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,188

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: $1,469 (412%)

Insurance Median: $2,188 (614%)

Cash: $1,469 (412% of Medicare)

Ins. Median: $2,188 (614% 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 614% of the Medicare baseline (a markup of 514%). 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
Humana	$303 - $5,996	85%
Aetna	$331 - $5,996	93%
Blue Cross Blue Shield	$331 - $26,250	93%
Buckeye Community Health	$331 - $9,481	93%
Medical Mutual	$331 - $33,500	93%
Medicare (plans)	$331 - $5,996	93%
Medigold	$336 - $6,117	94%
Molina	$336 - $10,093	94%
UnitedHealthcare	$336 - $6,117	94%
Va Ccn	$336 - $6,117	94%
The Health Plan	$338 - $6,116	95%
Valor Health Plan	$338 - $6,116	95%
Caresource	$343 - $7,952	96%
Medicaid / KanCare	$358	100%
Amerihealth Caritas Ohio	$376	105%
Oscar	$437 - $6,403	123%
Bwc	$467 - $8,497	131%
Allied Benefit Systems	$2,269	637%
Meritain Health	$2,269	637%
Quality Care Partners/Ohio Ppo Connect	$2,351	660%
The Ohio State Health Plan	$2,514	705%
Cigna	$2,690	755%
Ohio Healthy	$3,069	861%
Multiplan	$3,102	870%
Miscellaneous Plans	$3,265	916%

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 $1,469.
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 Fairfield Medical Center 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.