CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Mary Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $677
Cash Discount Price: $2,768
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Mary Medical Center is $677. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,768. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.90x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$2,768

Average discount available for prompt cash payment at this facility.

Insurance Median

$677

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: $2,768 (777%)

Insurance Median: $677 (190%)

Cash: $2,768 (777% of Medicare)

Ins. Median: $677 (190% 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
Medicaid / KanCare	$301 - $814	84%
Blue Cross Blue Shield	$376	105%
Cigna	$380 - $2,313	107%
Align Senior Care	$384	108%
Medicare (plans)	$386 - $677	108%
Aetna	$398 - $1,963	112%
UnitedHealthcare	$442 - $2,061	124%
Health America Advantra	$451	127%
Pace-Trinity Health	$468	131%
Ambetter / Centene	$671	188%
Oscar	$677	190%
Prime Healthcare	$677	190%
Jefferson Health Plan Commercial	$685	192%
Homestead Health Plans Woods Center	$733	206%
Keystone First	$814	228%
Keystone First Chip	$814	228%
Group Pension Administrators	$846	237%
Reedman Toll	$846	237%
Blue Shield - Pa (Highmark)	$1,017	285%
Geha	$1,738	488%
Meritain	$1,963	551%
Upmc Health Plan	$2,313	649%
Webtpa	$2,313	649%
Multiplan	$3,833	1075%
Prime Health Services	$3,833	1075%
Galaxy Health Network	$4,046	1135%
Three Rivers Provider Network	$4,046	1135%

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 $2,768.
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 St Mary Medical Center 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.