CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Licking Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $4,741
  • Cash Discount Price: $5,796
  • vs. Medicare Baseline: 13.30x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Licking Memorial Hospital is $4,741. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,796. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 13.30x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$5,796

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,741

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: $5,796 (1626%)
Insurance Median: $4,741 (1330%)
Cash: $5,796 (1626% of Medicare)
Ins. Median: $4,741 (1330% 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 1330% of the Medicare baseline (a markup of 1230%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Tricare $330 93%
Aetna $336 - $4,787 94%
Blue Cross Blue Shield $336 94%
Champva [500001] $336 94%
Cigna $336 - $5,216 94%
Humana $336 - $5,622 94%
Medicare (plans) $336 94%
UnitedHealthcare $336 - $4,926 94%
Veterans Administration [100068] $336 94%
Wellcare By Allwell [450104] $336 94%
Molina Marketplace [100106] $538 151%
Medical Mutual [100114] $3,188 - $4,810 894%
Medben [700068] $4,057 - $5,680 1138%
Benicomp [70090] $4,347 1220%
Consociate Health 6 Degrees [100059] $4,637 1301%
Consociate Health [100029] $4,637 1301%
Allied Benefit Systems [100015] $4,741 1330%
Geha [100039] $4,741 1330%
Gravie Administrative Services [100165] $4,741 1330%
Meritain [100063] $4,741 1330%
Optima [700069] $4,741 1330%
Trustmark Small Business Benefits [100263] $4,741 1330%
Webtpa [100127] $4,741 1330%
Healthscope [100157] $4,926 1382%
Surest [100016] $4,926 1382%
United Medical Resources [700071] $4,926 1382%
American Postal Workers [100089] $5,216 1463%
Antidote Health Plan Of Ohio [70006803] $5,216 1463%
Coresource [100002] $5,216 - $5,796 1463%
Great West Life [700064] $5,216 1463%
National Association Of Letter Carriers [100067] $5,216 1463%
Ohio Healthy Luminare Health [100264] $5,216 1463%
Ohio Healthy [100255] $5,216 1463%
Ohio Ppo Connect [70006801] $5,216 1463%
Osu Prime Care [100254] $5,216 1463%
Quality Care Partners [70006802] $5,216 1463%
The Health Plan [100261] $5,216 1463%
Wellfleet Group, Llc [100164] $5,216 1463%
Coventry [100010] $5,349 1501%
Pan American Life [700070] $5,349 1501%
Ohio Health Choice [100109] $5,564 1561%
Administrative Concepts [100006] $5,622 1577%
Carefactor [100087] $5,622 1577%
Philadelphia American Life [100260] $5,622 - $5,796 1577%
Reliance Standard-Asrm [100258] $5,622 1577%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals