CMS Price Transparency Data
MRI, brain (no contrast)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 70551 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70551
- Insurance Median: $736
- Cash Discount Price: $1,594
- vs. Medicare Baseline: 3.02x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Saint Alphonsus Medical Center Ontario is $736. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,594. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.02x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$1,594
Average discount available for prompt cash payment at this facility.
Insurance Median
$736
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$243.77
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $1,594 (654%)
Insurance Median: $736 (302%)
Cash: $1,594 (654% of Medicare)
Ins. Median: $736 (302% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $243.77 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 302% of the Medicare baseline (a markup of 202%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $154 - $736 | 63% |
| Blue Cross Blue Shield | $278 - $2,084 | 114% |
| Medicare (plans) | $278 - $298 | 114% |
| UnitedHealthcare | $278 - $2,354 | 114% |
| Aetna | $287 - $2,322 | 118% |
| American Health Advantage Of Idaho | $290 | 119% |
| Moda Health | $552 - $2,378 | 226% |
| Healthcare Management Admin | $666 | 273% |
| Blue Benefit Administrators Of Massachusetts | $696 | 286% |
| Blue Care Network | $696 | 286% |
| Blue Distinction Transplant | $696 | 286% |
| Blue Shield - Ca | $696 | 286% |
| Blue Shield - Id (Regence) | $696 | 286% |
| Blue Shield - Ny Highmark Northeastern | $696 | 286% |
| Blue Shield - Ny Highmark Western | $696 | 286% |
| Blue Shield - Pa (Highmark) | $696 | 286% |
| Blue Shield - Wa (Regence) | $696 | 286% |
| Ada County Jail Inmate Ins | $736 | 302% |
| Ambetter / Centene | $736 | 302% |
| Amish Mennonite | $736 | 302% |
| Bcccp-Michigan | $736 | 302% |
| Bccp | $736 | 302% |
| Bmc Healthnet | $736 | 302% |
| Breast Grant-Connecticut | $736 | 302% |
| California Health And Wellness | $736 | 302% |
| Cardinal Innovations Lme | $736 | 302% |
| Care Oregon Ohp | $736 | 302% |
| Cencal Health Plan | $736 | 302% |
| Cenpatico | $736 | 302% |
| Centurion Of Idaho | $736 | 302% |
| Chhuny | $736 | 302% |
| Childrens Comm Health Plan | $736 | 302% |
| Childrens Medical Services Title 19 | $736 | 302% |
| Cigna | $736 - $2,305 | 302% |
| Community Benefit Health | $736 | 302% |
| Community Care Behavorial Health | $736 | 302% |
| Community Health Choice | $736 | 302% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $736 | 302% |
| Dean Wi Badgercare | $736 | 302% |
| Delaware First Health | $736 | 302% |
| Delta Dental Nj | $736 | 302% |
| Dph Tb Program | $736 | 302% |
| Dscc | $736 | 302% |
| Eastpointe Lme | $736 | 302% |
| Family Health Network | $736 | 302% |
| Freedom First Healthcare | $736 | 302% |
| Ghc Scw Wi Badgercare | $736 | 302% |
| Harbor Health | $736 | 302% |
| Health Safety Net | $736 | 302% |
| Healthy Blue Ne | $736 | 302% |
| Hennepin Health | $736 | 302% |
| Humana | $736 - $2,158 | 302% |
| Id County Ada | $736 | 302% |
| Id County Canyon | $736 | 302% |
| Id County Cat Fund | $736 | 302% |
| Id County Payette | $736 | 302% |
| Idaho Womens Health Check | $736 | 302% |
| Indiana Breast Cervical Cancer | $736 | 302% |
| Inland Empire Health Plan | $736 | 302% |
| Intercommunity Health Ohp | $736 | 302% |
| Iowa Total Care | $736 | 302% |
| Jai Medical System | $736 | 302% |
| Kern Family Health Plan | $736 | 302% |
| Keystone First | $736 | 302% |
| Keystone First Chip | $736 | 302% |
| La Care Health Plan | $736 | 302% |
| Lakeland Care Inc | $736 | 302% |
| Managed Health Services - Indiana | $736 | 302% |
| Maryland Breast & Cervical Program | $736 | 302% |
| Maryland Healthy Smiles - Scion Dental | $736 | 302% |
| Maryland Physicians Care | $736 | 302% |
| Massachusetts Behavioral Health Partnership | $736 | 302% |
| Mdwise | $736 | 302% |
| Medi-Cal | $736 | 302% |
| Medi-Cal Healthnet | $736 | 302% |
| Medstar Dc Healthy Family | $736 | 302% |
| Medstar Md Health Choice | $736 | 302% |
| Mo Home State Health Plan | $736 | 302% |
| Molina Centennial Care | $736 | 302% |
| Nascentia Health Options | $736 | 302% |
| Nebraska Total Care | $736 | 302% |
| New York Cancer Services Program | $736 | 302% |
| Nextlevel Health | $736 | 302% |
| Oregon Screenwise | $736 | 302% |
| Pace Of Southwest Michigan | $736 | 302% |
| Paramount Advantage | $736 | 302% |
| Parkland Community Health Plan | $736 | 302% |
| Partners Behavioral Lme | $736 | 302% |
| Peach State Healthplan | $736 | 302% |
| Presbyterian Centennial Care | $736 | 302% |
| Prestige Health Choice | $736 | 302% |
| Priority Partners | $736 | 302% |
| Rx 340B Pass Along | $736 | 302% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $736 | 302% |
| Rx Medi-Cal | $736 | 302% |
| Rx Meridian Rx | $736 | 302% |
| Sandhills Center Lme | $736 | 302% |
| Screening For Life | $736 | 302% |
| Sunshine State Health Plan | $736 | 302% |
| Superior Health | $736 | 302% |
| Tenncare | $736 | 302% |
| Texas Children'S Health Plan | $736 | 302% |
| Trillium Community Ohp | $736 | 302% |
| Tufts Health Public Plans | $736 | 302% |
| Vaya Health Lme | $736 | 302% |
| Wellsense Health Plan | $736 | 302% |
| Wi Womens Wellness | $736 | 302% |
| Webtpa | $750 - $2,207 | 308% |
| Selecthealth | $920 - $2,207 | 377% |
| Mountain Health Co-Op | $1,471 | 603% |
| Pacificsource Health Plans | $1,471 - $2,305 | 603% |
| Allegiance | $1,864 | 765% |
| Correctional Health Partners | $1,913 | 785% |
| Columbia Health Network | $1,962 | 805% |
| Healthnet | $2,060 | 845% |
| Allied National Global Care | $2,207 | 905% |
| Asrm - Reliance Standard Life Insurance | $2,207 | 905% |
| Christian Care Ministry | $2,207 | 905% |
| Dean Health | $2,207 | 905% |
| Fallon Health | $2,207 | 905% |
| Family Life Insurance Company | $2,207 | 905% |
| First Choice Health | $2,207 | 905% |
| Ghc Scw | $2,207 | 905% |
| International Benefit Administrators | $2,207 | 905% |
| Lifetime Benefit Solutions | $2,207 | 905% |
| Manhattan Life | $2,207 | 905% |
| Pai | $2,207 | 905% |
| Pan-American Life | $2,207 | 905% |
| Paramount Hmo | $2,207 | 905% |
| Phcs | $2,207 | 905% |
| Trinity Health Share | $2,207 | 905% |
| Lifewise | $2,280 | 935% |
| Priority Health | $2,305 | 946% |
| Allied Benefit Systems | $2,322 | 953% |
| Ameriben | $2,322 | 953% |
| Asr Health Benefits | $2,322 | 953% |
| Christian Brother Services | $2,322 | 953% |
| Geha | $2,322 - $2,354 | 953% |
| Healthez | $2,322 | 953% |
| Luminare Health (Detroit) | $2,322 | 953% |
| Rural Carrier Health Benefit Plan | $2,322 | 953% |
| First Health | $2,329 | 955% |
| Medi Share | $2,329 | 955% |
| Providence | $2,329 | 955% |