CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lower Bucks Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $360
  • Cash Discount Price: $343
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lower Bucks Hospital is $360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.01x the Medicare baseline. Located in 501 Bath Road, Bristol, PA.
Cash / Self-Pay
$343

Average discount available for prompt cash payment at this facility.

Insurance Median
$360

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: $343 (96%)
Insurance Median: $360 (101%)
Cash: $343 (96% of Medicare)
Ins. Median: $360 (101% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Health Partners Plan $269 - $515 75%
Medicaid / KanCare $269 75%
Humana $275 77%
Keystone $285 - $357 80%
UnitedHealthcare $304 - $733 85%
Blue Cross Blue Shield $343 - $2,061 96%
Medicare (plans) $343 - $360 96%
Pa Health & Wellness $343 - $412 96%
Tricare $343 96%
Provider Patners Health Plan $354 99%
Spartan Plan Pa $360 101%
Auto Insurance $378 106%
Worker Compensation $388 109%
One Call Care $468 131%
Employer Direct Healthcare $480 135%
Highmark $764 214%
Cigna $830 233%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Bath Road, Bristol, PA 19007
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals