CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UPMC McKeesport Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,831
Cash Discount Price: $6,049
vs. Medicare Baseline: 10.75x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UPMC McKeesport Hospital is $3,831. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,049. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.75x the Medicare baseline. Located in 1500 Fifth Avenue, Mc Keesport, PA.

Cash / Self-Pay

$6,049

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,831

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: $6,049 (1697%)

Insurance Median: $3,831 (1075%)

Cash: $6,049 (1697% of Medicare)

Ins. Median: $3,831 (1075% 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 1075% of the Medicare baseline (a markup of 975%). 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
Upmc Health Plan	$316 - $3,812	89%
Aetna	$358 - $4,033	100%
Amerihealth Caritas	$368 - $529	103%
Highmark Wholecare (Prev Gateway)	$368 - $503	103%
Pa Health & Wellness	$368 - $578	103%
UnitedHealthcare	$373	105%
Blue Cross Blue Shield	$1,214 - $6,130	341%
Premier Comp Solutions	$2,429	681%
Upmc Work Partners	$2,611	733%
Cigna	$3,882 - $6,049	1089%
Intergroup	$5,041	1414%
Coventry/First Health	$7,057	1980%
Private Health Care Systems	$8,066	2263%
Selectcare	$8,066	2263%
Humana	$8,570	2404%

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 $6,049.
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 UPMC McKeesport 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.