CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $2,360
- Cash Discount Price: $3,652
- vs. Medicare Baseline: 6.62x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Hospital Ardmore, Inc is $2,360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,652. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.62x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$3,652
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,360
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: $3,652 (1025%)
Insurance Median: $2,360 (662%)
Cash: $3,652 (1025% of Medicare)
Ins. Median: $2,360 (662% 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 662% of the Medicare baseline (a markup of 562%). 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 |
|---|---|---|
| Aetna | $183 - $3,574 | 51% |
| Humana | $183 - $3,877 | 51% |
| Medicaid / KanCare | $183 - $491 | 51% |
| Blue Cross Blue Shield | $357 | 100% |
| Cherokee Nation Health Serv Contracted [320066] | $357 | 100% |
| Cross Timbers Hospice [20098] | $357 | 100% |
| Dept Of Veteran Affairs Contracted [320106] | $357 | 100% |
| Elara Caring Aspire Hospice Contracted [320433] | $357 | 100% |
| Elara Caring Aspire Hospice [20433] | $357 | 100% |
| Halo Hcr Inc Hospice Contracted [320432] | $357 | 100% |
| Halo Hcr Inc Hospice [20432] | $357 | 100% |
| Independent Health [20197] | $357 | 100% |
| Indian Health Service Contracted [320198] | $357 | 100% |
| Kindful Hospice Contracted [320434] | $357 | 100% |
| Kindful Hospice [20434] | $357 | 100% |
| Medical Associates Health [20444] | $357 | 100% |
| Medicare (plans) | $357 - $5,619 | 100% |
| Mercy Hospice Okc [20252] | $357 | 100% |
| Provider Partners Health Plans Contracted [320450] | $357 | 100% |
| Qual Choice Contracted [320325] | $357 | 100% |
| Tribute Health Plan Mcr Contracted [320338] | $357 | 100% |
| Tricare | $357 | 100% |
| Globalhealth Contracted [320145] | $364 | 102% |
| UnitedHealthcare | $364 - $1,513 | 102% |
| Cigna | $368 - $2,158 | 103% |
| Ambetter / Centene | $491 | 138% |
| Home State Health Plan Contracted [320187] | $491 | 138% |
| Novasys Contracted [320285] | $491 | 138% |
| Globalhealth Contracted [320144] | $520 | 146% |
| Administrative Payor Contracted [320005] | $535 | 150% |
| Community Care Contracted [320080] | $546 - $3,933 | 153% |
| Workers Comp [20426] | $641 | 180% |
| Medica Contracted [320239] | $733 - $5,619 | 206% |
| Healthsmart Preferred Care Contracted [320184] | $803 - $3,652 | 225% |
| Kempton Contracted [320214] | $803 | 225% |
| Health Choice Contracted [320166] | $982 | 276% |
| United Medical Resources Contracted [320454] | $1,513 - $3,652 | 424% |
| Healthcare Highways Plus Contracted [320175] | $2,191 - $3,371 | 615% |
| Webtpa Contracted [320417] | $2,360 | 662% |
| Osma Health Contracted [320292] | $2,529 | 710% |
| Aither Health Contracted [320449] | $3,371 | 946% |
| Auxiant Contracted [320462] | $3,371 - $3,652 | 946% |
| Benefit Management Contracted [320052] | $3,371 - $3,652 | 946% |
| Ebms Contracted [320493] | $3,371 | 946% |
| Healthlink Contracted [320179] | $3,371 - $3,652 | 946% |
| Imagine 360 Contracted [320494] | $3,371 | 946% |
| Mercy Benefit Admin Contracted [320251] | $3,371 - $3,652 | 946% |
| Quik Trip Contracted [320447] | $3,371 | 946% |
| Reflect Health Contracted [320492] | $3,371 | 946% |
| Show-Me Health Administrators Contracted [320483] | $3,371 | 946% |
| Yuzu Health Contracted [320521] | $3,371 | 946% |
| Federal Medical Center Contracted [320127] | $3,652 | 1025% |
| Healthscope Contracted [320182] | $3,652 | 1025% |
| Healthsmart Accel Contracted [320183] | $3,652 | 1025% |
| Point C Contracted [320238] | $3,652 | 1025% |
| Preferred Health Plan Contracted [320522] | $3,652 | 1025% |
| Tri State Healthcare Coalition Contracted [320379] | $3,652 | 1025% |
| First Health Contracted [320128] | $3,737 | 1048% |
| Private Health Care Systems Contracted [320320] | $4,214 - $4,495 | 1182% |
| Preferred Community Choice Contracted [320311] | $4,270 | 1198% |
| Multiplan Contracted [320270] | $4,495 - $5,057 | 1261% |