CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Galion Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,630
Cash Discount Price: $4,017
vs. Medicare Baseline: 10.18x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Galion Community Hospital is $3,630. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,017. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.18x the Medicare baseline. Located in 269 Portland Way South, Galion, OH.

Cash / Self-Pay

$4,017

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,630

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: $4,017 (1127%)

Insurance Median: $3,630 (1018%)

Cash: $4,017 (1127% of Medicare)

Ins. Median: $3,630 (1018% 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 1018% of the Medicare baseline (a markup of 918%). 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
Caresource	$652	183%
Medicaid / KanCare	$652	183%
Ohiorise	$652	183%
Molina	$665 - $5,629	187%
Blue Cross Blue Shield	$671 - $4,142	188%
Amerihealth	$684	192%
United_Healthcare	$684 - $4,348	192%
Buckeye	$705 - $4,142	198%
Humana	$705 - $4,142	198%
Medicare (plans)	$1,607 - $4,142	451%
Mount_Carmel	$1,607 - $4,142	451%
Aetna	$1,639 - $4,224	460%
Medical_Mutual	$3,781 - $4,224	1061%
Cigna	$4,159	1167%

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 $4,017.
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 Galion 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.