CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Fostoria Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,478
Cash Discount Price: $3,098
vs. Medicare Baseline: 6.95x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Fostoria Community Hospital is $2,478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,098. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.95x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$3,098

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,478

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: $3,098 (869%)

Insurance Median: $2,478 (695%)

Cash: $3,098 (869% of Medicare)

Ins. Median: $2,478 (695% 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 695% of the Medicare baseline (a markup of 595%). 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
Meridian Health Plan Of Mi	$191	54%
Paramount Health Care	$284 - $2,526	80%
Blue Cross Blue Shield	$292 - $3,088	82%
Health Alliance Plan	$292 - $3,574	82%
Health Value Management	$292 - $1,032	82%
Buckeye Community Health Plan	$300 - $1,063	84%
Buckeye Community Health Plan Inc	$332 - $1,730	93%
Aetna	$335 - $3,193	94%
Dayton Area Health Plan Dba Caresource	$460 - $1,978	129%
UnitedHealthcare	$568 - $2,850	159%
Amerihealth	$595	167%
Veterans Affairs	$1,049	294%
Medical Mutual Of Ohio	$2,693 - $2,864	756%
Frontpath Health Coalition	$2,745	770%
Ohio Health Choice	$3,098	869%
Ohio Ppo Connect	$3,098 - $3,574	869%
Health Ohio Network	$3,765	1056%
Connecticut General Life Insurance Company	$3,803	1067%

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 $3,098.
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 Fostoria 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.