CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,859
  • Cash Discount Price: $19,502
  • vs. Medicare Baseline: 10.83x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Hospital of Univ of Pennsylvania is $3,859. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,502. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.83x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$19,502

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,859

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: $19,502 (5471%)
Insurance Median: $3,859 (1083%)
Cash: $19,502 (5471% of Medicare)
Ins. Median: $3,859 (1083% 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 1083% of the Medicare baseline (a markup of 983%). 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
Gspp And Wissahickon Hospice $183 51%
Medicaid / KanCare $269 - $19,502 75%
Kaiser Permanente $282 - $19,502 79%
Health Partners $320 - $19,502 90%
UnitedHealthcare $323 - $19,502 91%
Pa Medical Assistance $339 - $19,502 95%
Keystone Mercy Health Plan $344 - $19,502 97%
Blue Cross Blue Shield $367 - $10,653 103%
Medicare (plans) $367 - $374 103%
Philadelphia Va Medical Center $367 103%
Tricare $367 103%
Upmc $367 - $19,502 103%
Ibc $374 105%
Cigna $378 - $8,776 106%
Geisinger Health Plan $378 - $1,163 106%
Humana $378 - $15,602 106%
Devoted Health $385 108%
Pa Health And Wellness $385 - $605 108%
Penn Life (Living Independently For Elders) $385 108%
Aetna $389 - $19,502 109%
Clover Health Plan $396 111%
Keystone First $407 114%
Us Family Health Plan $422 118%
Gateway Health Plan $455 128%
Elap $521 146%
Paired Kidney Exchange $585 164%
Claims Watcher $587 - $660 165%
Oscar Health Plan $623 175%
Centivo $660 185%
Elap Services $682 191%
Highmark $771 216%
Keystone Hmo Proactive $846 237%
Ibc Commercial Hpn $874 245%
Penn Global Medicine $972 273%
Horizon Nj Health $3,296 - $3,428 925%
Preferred Health Care Eliance $4,290 1204%
Pgm - Regie De L'Assurance Maladie Quebec $4,485 1258%
Pgm - Kuwait Defense $6,826 - $8,776 1915%
Qualcare $7,411 2079%
Olympus $7,664 2150%
Coventry $7,801 - $9,946 2189%
Pgm - Chop $7,801 2189%
Wissahickon Hospice $7,801 2189%
Healthamerica/Coventry $8,776 - $9,556 2462%
First Health Global $9,751 2736%
Health Net $11,701 3283%
Pgm - Royal Embassy Of Saudi Arabia $11,701 3283%
Pgm - Embassy Of Qatar $12,676 3556%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $12,676 3556%
Interlink $13,066 3666%
Pgm - Embassy Of The United Emirates/Ipc $13,651 3830%
Health America/Ccn $15,602 4377%
Intergroup $15,602 4377%
Pgm - Kuwait Health Division $15,602 4377%
Pgm - Kuwait Oil $15,602 4377%
Preferred Care $15,602 4377%
Blue Quality Centers For Transplant (Bqct) $19,502 5471%
City Of Philadelphia Behavioral Health $19,502 5471%
Commercial Other $19,502 5471%
International Pfs $19,502 5471%
United Behavioral Health $19,502 5471%
Workers Compensation $19,502 5471%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals