CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Pennsylvania Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $2,387
  • Cash Discount Price: $9,181
  • vs. Medicare Baseline: 9.79x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Pennsylvania Hospital is $2,387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,181. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.79x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$9,181

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,387

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: $9,181 (3766%)
Insurance Median: $2,387 (979%)
Cash: $9,181 (3766% of Medicare)
Ins. Median: $2,387 (979% 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 979% of the Medicare baseline (a markup of 879%). 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 - $9,181 83%
Blue Cross Blue Shield $250 - $9,181 103%
Medicare (plans) $250 - $255 103%
Philadelphia Va Medical Center $250 103%
Upmc $250 - $9,181 103%
Tricare $251 103%
Ibc $255 105%
Cigna $257 - $374 105%
Geisinger Health Plan $257 - $791 105%
Humana $257 - $7,345 105%
Pa Health And Wellness $262 - $412 107%
Penn Life (Living Independently For Elders) $262 107%
Aetna $265 - $9,181 109%
UnitedHealthcare $265 - $9,181 109%
Gateway Health Plan $269 - $309 110%
Medicaid / KanCare $269 - $9,181 110%
Clover Health Plan $270 111%
Keystone First $277 114%
Us Family Health Plan $288 118%
Pa Medical Assistance $338 139%
Keystone Mercy Health Plan $344 141%
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 $1,552 - $1,614 637%
Pgm - Regie De L'Assurance Maladie Quebec $2,112 866%
Preferred Health Care Eliance $2,387 979%
Pgm - Kuwait Defense $3,213 - $4,131 1318%
Devon $3,489 - $4,131 1431%
Qualcare $3,489 1431%
Coventry $3,672 - $4,682 1506%
Pgm - Chop $3,672 1506%
Wissahickon Hospice $3,672 1506%
Healthamerica/Coventry $4,131 - $4,499 1695%
Olympus $4,462 1830%
First Health Global $4,590 1883%
Urn-Cancer Resource Services $4,590 1883%
Health Net $5,509 2260%
Pgm - Royal Embassy Of Saudi Arabia $5,509 2260%
Pgm - Embassy Of Qatar $5,968 2448%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $5,968 2448%
Pgm - Embassy Of The United Emirates/Ipc $6,427 2637%
Devon Health Services Inc $7,345 3013%
Health America/Ccn $7,345 3013%
Intergroup $7,345 3013%
Pgm - Kuwait Health Division $7,345 3013%
Pgm - Kuwait Oil $7,345 3013%
Preferred Care $7,345 3013%
Commercial Other $9,181 3766%
Community Behavioral Health $9,181 3766%
International Pfs $9,181 3766%
Quest Behavioral Health $9,181 3766%
United Behavioral Health $9,181 3766%
Workers Compensation $9,181 3766%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals