CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lancaster General Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,545
  • Cash Discount Price: $1,818
  • vs. Medicare Baseline: 4.33x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lancaster General Hospital is $1,545. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,818. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.33x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$1,818

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,545

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: $1,818 (510%)
Insurance Median: $1,545 (433%)
Cash: $1,818 (510% of Medicare)
Ins. Median: $1,545 (433% 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 433% of the Medicare baseline (a markup of 333%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $269 - $691 75%
UnitedHealthcare $296 - $3,265 83%
Gateway $315 88%
Tricare $319 89%
Hospice And Community Care $345 - $730 97%
Highmark $351 - $3,841 98%
Albright Life $354 99%
Coatesville Va $354 99%
Hospice Generic $354 99%
Lebanon Veterans Hospital $354 99%
Medicare (plans) $354 - $392 99%
Aetna $358 - $2,600 100%
Blue Cross Blue Shield $360 - $3,841 101%
Amerihealth Caritas $362 102%
Cigna $365 - $2,899 102%
Health Partners Mcr Advantage $365 102%
Devoted Health $372 104%
Pa Health And Wellness Mcr $372 104%
Old Order Group $491 - $1,229 138%
Elap Employees $503 141%
Upmc For You $506 142%
Lg Coresource/Lg Eliance $518 - $1,095 145%
Lancashire Hall $545 - $3,841 153%
Nursing Home Op Services $545 - $1,152 153%
Oscar Health Plan $691 194%
Affilia Home Health $727 - $3,841 204%
Masonic Homes $764 - $3,841 214%
Claim Watcher Plus $1,063 298%
Eliance Health Solutions $1,164 - $2,458 327%
Claim Watcher $1,170 328%
Highmark Commercial Preferred $1,216 - $3,841 341%
Elap Other Groups $1,290 362%
Ehp $1,491 - $3,150 418%
Upmc Commercial $1,491 - $3,265 418%
Devon $1,545 - $3,265 433%
Geisinger Commercial $1,545 - $3,265 433%
Intergroup Services $1,545 - $3,265 433%
Preferred Healthcare $1,545 - $3,265 433%
Medi-Share Christian Care $1,727 - $3,649 485%
Commercial Generic $1,818 - $3,841 510%
Highmark Commercial Non-Preferred $1,818 - $3,872 510%
Magellan $1,818 - $3,841 510%
United Behavioral Health $1,818 - $3,841 510%
Value Options $1,818 - $3,841 510%
Workers Compensation $1,818 - $3,841 510%
Gift Of Life Donor Program $13,500 3788%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals