CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Geisinger-Lewistown Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,782
Cash Discount Price: $4,221
vs. Medicare Baseline: 7.81x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Geisinger-Lewistown Hospital is $2,782. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,221. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.81x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$4,221

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,782

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: $4,221 (1184%)

Insurance Median: $2,782 (781%)

Cash: $4,221 (1184% of Medicare)

Ins. Median: $2,782 (781% 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 781% of the Medicare baseline (a markup of 681%). 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
Medicaid / KanCare	$339	95%
Blue Cross Blue Shield	$346 - $3,683	97%
Geisinger Health Plan	$346 - $1,821	97%
Medicare (plans)	$346	97%
Upmc Health Plan	$346 - $11,890	97%
Advantra	$350	98%
Humana	$350	98%
Geisinger Family Plan	$363	102%
Amerihealth	$373	105%
Health Partners	$407	114%
Upmc Chip	$424	119%
Ambetter / Centene	$831	233%
Aetna	$2,782 - $3,309	781%
Cigna	$2,944 - $3,581	826%
UnitedHealthcare	$3,016	846%
Christian Healthcare Ministries	$3,404	955%
Christian Health Aid	$5,446	1528%
Three Rivers Provider Network Inc.	$5,446	1528%
Multiplan	$5,787	1624%
Healthsmart Payors Organization	$6,127	1719%

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 $4,221.
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 Geisinger-Lewistown 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.