CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Wellspan Waynesboro Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,284
Cash Discount Price: $702
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Wellspan Waynesboro Hospital is $1,284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $702. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.60x the Medicare baseline. Located in 501 East Main St, Waynesboro, PA.

Cash / Self-Pay

$702

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,284

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: $702 (197%)

Insurance Median: $1,284 (360%)

Cash: $702 (197% of Medicare)

Ins. Median: $1,284 (360% 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 360% of the Medicare baseline (a markup of 260%). 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
Medicaid / KanCare	$121 - $628	34%
Medicare (plans)	$356 - $476	100%
Highmark	$381 - $1,461	107%
Aetna	$392 - $3,141	110%
Wellspan_Capital_Blue_Cross	$721	202%
United_Healthcare	$2,107	591%
Upmc	$2,554	717%
Cigna	$2,740 - $3,275	769%
Blue_Cross	$3,139 - $4,484	881%
Geisinger	$3,149	883%
First_Health_Network	$4,043	1134%

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 $702.
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 Wellspan Waynesboro Hospital 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.