CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $441
Cash Discount Price: $4,140
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Nationwide Children's Hospital Toledo, LLC is $441. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,140. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.24x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$4,140

Average discount available for prompt cash payment at this facility.

Insurance Median

$441

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: $4,140 (1162%)

Insurance Median: $441 (124%)

Cash: $4,140 (1162% of Medicare)

Ins. Median: $441 (124% 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.

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	$103 - $374	29%
Paramount	$103	29%
Blue Cross Blue Shield	$108 - $3,519	30%
Front Path Health Coalition	$134 - $3,105	38%
Mcclaren Health Plan	$144 - $3,105	40%
Aetna	$198 - $2,656	56%
UnitedHealthcare	$272 - $3,484	76%
Cigna	$337 - $1,017	95%
Molina	$356 - $436	100%
Mcclaren Health Plan - Michigan	$367	103%
Amerihealth	$441	124%
Bchp	$441	124%
Humana	$441	124%
Ohc	$511 - $3,450	143%
Ohio Ppo Connect	$511 - $3,450	143%
Mmo	$1,725 - $2,415	484%
First Health	$5,313	1491%

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 $4,140.
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 Nationwide Children's Hospital Toledo, LLC 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.