CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Penn Presbyterian Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $2,163
  • Cash Discount Price: $6,802
  • vs. Medicare Baseline: 8.87x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Penn Presbyterian Medical Center is $2,163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,802. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.87x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$6,802

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,163

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $6,802 (2790%)
Insurance Median: $2,163 (887%)
Cash: $6,802 (2790% of Medicare)
Ins. Median: $2,163 (887% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 887% of the Medicare baseline (a markup of 787%). 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
Health Partners $203 - $6,802 83%
Blue Cross Blue Shield $250 - $6,802 103%
Medicare (plans) $250 - $255 103%
Philadelphia Va Medical Center $250 103%
Upmc $250 - $6,802 103%
Tricare $251 103%
Ibc $255 105%
Cigna $257 - $374 105%
Geisinger Health Plan $257 - $791 105%
Humana $257 - $5,442 105%
Pa Health And Wellness $262 - $412 107%
Penn Life (Living Independently For Elders) $262 107%
Aetna $265 - $6,802 109%
UnitedHealthcare $265 - $6,802 109%
Medicaid / KanCare $269 - $6,802 110%
Clover Health Plan $270 111%
Keystone First $277 114%
Us Family Health Plan $288 118%
Gateway Health Plan $309 127%
Pa Medical Assistance $338 139%
Keystone Mercy Health Plan $344 - $6,802 141%
Elap $354 145%
Claims Watcher $399 - $449 164%
Oscar Health Plan $424 174%
Centivo $449 184%
Elap Services $464 190%
Keystone Hmo Proactive $522 214%
Highmark $525 215%
Ibc Commercial Hpn $539 221%
Penn Global Medicine $661 271%
Horizon Nj Health $1,150 - $1,196 472%
Pgm - Regie De L'Assurance Maladie Quebec $1,564 642%
Preferred Health Care Eliance $1,700 697%
Pgm - Kuwait Defense $2,381 - $3,061 977%
Devon $2,585 - $3,061 1060%
Qualcare $2,585 1060%
Coventry $2,721 - $3,469 1116%
Pgm - Chop $2,721 1116%
Wissahickon Hospice $2,721 1116%
Healthamerica/Coventry $3,061 - $3,333 1256%
Olympus $3,224 1323%
First Health Global $3,401 1395%
Urn-Cancer Resource Services $3,401 1395%
Health Net $4,081 1674%
Pgm - Royal Embassy Of Saudi Arabia $4,081 1674%
Pgm - Embassy Of Qatar $4,421 1814%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $4,421 1814%
Pgm - Embassy Of The United Emirates/Ipc $4,761 1953%
Devon Health Services Inc $5,442 2232%
Health America/Ccn $5,442 2232%
Intergroup $5,442 2232%
Pgm - Kuwait Health Division $5,442 2232%
Pgm - Kuwait Oil $5,442 2232%
Preferred Care $5,442 2232%
Commercial Other $6,802 2790%
International Pfs $6,802 2790%
Magellan $6,802 2790%
Quest Behavioral Health $6,802 2790%
United Behavioral Health $6,802 2790%
Workers Compensation $6,802 2790%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals