CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UPMC Somerset

Billing Code: 70553 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$379

about 1.1× the $356 Medicare rate · typically $343–$484

modeled estimate · not a bill or quote

What this hospital charges insurers

$389

About the fair price

about $10 over the fair price · 1.1× Medicare

Medicare pays $356 Fair price $379 This hospital $389 Cash price $2,855 Hospital's list price $4,758

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $211 Priciest $389

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, brain (with and without contrast) is about $379 (about 1.1× the $356 Medicare rate). UPMC Somerset charges insurers about $389, or about $2,855 in cash — about the fair price. Located in Somerset, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$309 - $2,051	87%
Blue Cross Blue Shieldmajor	$337 - $1,190	95%
Aetnamajor	$1,903	534%
Humanamajor	$3,568	1001%
AmeriHealth	$340 - $389	95%
Geisinger	$471 - $1,874	132%
UPMC Health Plan	$340 - $3,812	95%

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,855), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 70553.

Insurance Before you use insurance

Call your insurance company to confirm UPMC Somerset is in-network.
Ask your insurer whether prior approval is required for CPT code 70553.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at UPMC Somerset

Compare: MRI, brain (with and without contrast) at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.