CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lodi Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,283
Cash Discount Price: $1,544
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lodi Community Hospital is $1,283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,544. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.60x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.

Cash / Self-Pay

$1,544

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,283

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: $1,544 (433%)

Insurance Median: $1,283 (360%)

Cash: $1,544 (433% of Medicare)

Ins. Median: $1,283 (360% 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 360% of the Medicare baseline (a markup of 260%). 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
Blue Cross Blue Shield	$357 - $1,943	100%
UnitedHealthcare	$357 - $1,472	100%
Buckeye	$474	133%
Caresource	$474	133%
Molina	$498	140%
United	$498 - $1,696	140%
Amerihealth	$522	146%
Humana	$712	200%
Mmo	$712 - $1,814	200%
Summacare	$712 - $1,456	200%
Oscar	$716 - $913	201%
Aetna	$808 - $2,375	227%
The Health Plan	$950 - $1,900	267%
Amish Community Aid Plan	$1,069 - $1,188	300%
Ohcp	$1,154	324%
Aultcare	$1,188	333%
Omas	$1,188	333%
Ohio Healthy	$1,282	360%
Php	$1,425	400%
Phphi	$1,425	400%
Upmc	$1,425	400%
Cigna	$1,532	430%
Cc Ehp	$1,596	448%
Gms	$1,662	466%
Medical Benefit Corp	$1,662	466%
Consociate Health	$1,781	500%
Frontpath	$2,138	600%
Managed Care Services	$2,138	600%
Multiplan	$2,138	600%
Tertiary Care Network	$2,138	600%

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 $1,544.
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 Lodi Community 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.