CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Excela Health - Frick Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $407
Cash Discount Price: $1,362
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Excela Health - Frick Hospital is $407. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,362. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.14x the Medicare baseline. Located in 508 South Church Street, Mount Pleasant, PA.

Cash / Self-Pay

$1,362

Average discount available for prompt cash payment at this facility.

Insurance Median

$407

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: $1,362 (382%)

Insurance Median: $407 (114%)

Cash: $1,362 (382% of Medicare)

Ins. Median: $407 (114% 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.

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
Highmark Advantage Community Blue	$332	93%
Senior Life	$356	100%
Va	$356	100%
Aetna	$367 - $820	103%
Health Partners Plan	$367	103%
Martin'S Point	$367	103%
Peak Health	$367 - $838	103%
The Health Plan Of West Virginia	$367 - $838	103%
Humana	$371	104%
United	$371	104%
Amerihealth Caritas	$374 - $441	105%
Cigna	$374 - $787	105%
Devoted	$374	105%
Geisinger	$374 - $407	105%
Pa Health And Wellness	$381 - $441	107%
Upmc	$385 - $431	108%
Highmark Wholecare	$389 - $417	109%
American Health Plan Of Pa	$392	110%
Provider Network Of America	$392 - $1,816	110%
Provider Plan Partners Plan	$392	110%
Health Partners Plans	$407	114%
Upmc Health Plan	$413 - $2,995	116%
Highmark Children'S Health Insurance Program	$429	120%
Ambetter / Centene	$446	125%
Highmark	$482 - $787	135%
Velocity	$535	150%
Upmc For Kids Chip	$681	191%
Community Blue	$708	199%
UnitedHealthcare	$908	255%

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 $1,362.
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 Excela Health - Frick 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.