CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UPMC Williamsport

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,024
Cash Discount Price: $3,804
vs. Medicare Baseline: 8.48x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UPMC Williamsport is $3,024. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,804. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.48x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$3,804

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,024

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: $3,804 (1067%)

Insurance Median: $3,024 (848%)

Cash: $3,804 (1067% of Medicare)

Ins. Median: $3,024 (848% 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 848% of the Medicare baseline (a markup of 748%). 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
Blue Cross Blue Shield	$344 - $2,971	97%
UnitedHealthcare	$344 - $4,337	97%
Upmc Health Plan	$347 - $2,764	97%
Aetna	$351 - $4,184	98%
Amerihealth Caritas	$351 - $382	98%
Highmark Wholecare (Prev Gateway)	$368 - $476	103%
Pa Health & Wellness	$368 - $578	103%
Geisinger	$373 - $4,248	105%
Upmc Work Partners	$2,611	733%
Three Rivers Provider Network	$2,793 - $5,706	784%
Multiplan	$2,884 - $4,945	809%
Coventry/First Health	$3,176 - $4,267	891%
Wirerope Works	$3,525	989%
Cigna	$4,343	1218%
America'S Choice	$5,072	1423%
Intergroup	$5,072	1423%

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 $3,804.
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 Williamsport 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.