CMS Price Transparency Data

MRI, brain (no contrast)

Facility: UPMC Pinnacle Hospitals

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $444
Cash Discount Price: $959
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at UPMC Pinnacle Hospitals is $444. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $959. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.82x the Medicare baseline. Located in 409 South Second Street, Harrisburg, PA.

Cash / Self-Pay

$959

Average discount available for prompt cash payment at this facility.

Insurance Median

$444

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: $959 (393%)

Insurance Median: $444 (182%)

Cash: $959 (393% of Medicare)

Ins. Median: $444 (182% 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.

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	$59 - $2,494	24%
Keystone Health Plan	$59 - $1,667	24%
Prime Net	$71 - $2,183	29%
Aetna	$173 - $2,137	71%
Intergroup	$190 - $2,468	78%
Humana	$245	101%
Wellspan Population Health	$249 - $2,468	102%
Cigna	$250	103%
UnitedHealthcare	$254 - $352	104%
Pa Health & Wellness	$257 - $575	105%
Premier Comp Solutions	$425	174%
Amerihealth Caritas	$429	176%
Health Partners Plans (Jefferson Health Plan)	$460	189%
Geisinger	$492	202%
Upmc Work Partners	$1,196	491%
Upmc Health Plan	$1,801	739%

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 $959.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Pinnacle Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.