CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UPMC Passavant

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,870
Cash Discount Price: $5,999
vs. Medicare Baseline: 8.05x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UPMC Passavant is $2,870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,999. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.05x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.

Cash / Self-Pay

$5,999

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,870

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: $5,999 (1683%)

Insurance Median: $2,870 (805%)

Cash: $5,999 (1683% of Medicare)

Ins. Median: $2,870 (805% 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 805% of the Medicare baseline (a markup of 705%). 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
Upmc Health Plan	$316 - $1,058	89%
Health Plan Of Upper Ohio Valley	$340 - $4,620	95%
Aetna	$358 - $375	100%
UnitedHealthcare	$358 - $390	100%
Amerihealth Caritas	$368 - $529	103%
Highmark Wholecare (Prev Gateway)	$368 - $503	103%
Pa Health & Wellness	$368 - $578	103%
Blue Cross Blue Shield	$1,214 - $7,241	341%
Premier Comp Solutions	$2,429	681%
Upmc Work Partners	$2,611	733%
Private Health Care Systems	$3,036 - $9,299	852%
Cigna	$3,400 - $4,000	954%
Coventry/First Health	$6,999	1964%
Intergroup	$8,299 - $8,999	2328%
Humana	$8,499 - $9,299	2384%
Multiplan	$8,499 - $9,299	2384%

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 $5,999.
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 Passavant 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.