CMS Price Transparency Data

MRI, brain (no contrast)

Facility: UPMC Hanover

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $429
Cash Discount Price: $959
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at UPMC Hanover is $429. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $959. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.76x the Medicare baseline. Located in 300 Highland Ave, Hanover, PA.

Cash / Self-Pay

$959

Average discount available for prompt cash payment at this facility.

Insurance Median

$429

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: $959 (393%)

Insurance Median: $429 (176%)

Cash: $959 (393% of Medicare)

Ins. Median: $429 (176% 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.

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
Blue Cross Blue Shield	$56 - $1,973	23%
Keystone Health Plan	$56 - $1,973	23%
Prime Net	$71 - $906	29%
Geisinger	$192 - $2,097	79%
Upmc Health Plan	$205 - $2,032	84%
UnitedHealthcare	$216 - $2,137	89%
Humana	$231	95%
Aetna	$241 - $3,211	99%
Cigna	$242 - $1,225	99%
Carefirst	$249 - $2,468	102%
Multiplan	$249 - $2,468	102%
Pa Health & Wellness	$249 - $575	102%
Wellspan Population Health	$255 - $2,526	105%
Keystone Autism Services	$369	151%
Onecall	$400	164%
Premier Comp Solutions	$425	174%
Amerihealth Caritas	$429	176%
Highmark Wholecare (Prev Gateway)	$429	176%
Health Partners Plans (Jefferson Health Plan)	$460	189%
Upmc Work Partners	$1,196	491%

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 $959.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Hanover is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.