CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UPMC Wellsboro

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,853
  • Cash Discount Price: $4,202
  • vs. Medicare Baseline: 10.81x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UPMC Wellsboro is $3,853. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,202. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.81x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.
Cash / Self-Pay
$4,202

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,853

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: $4,202 (1179%)
Insurance Median: $3,853 (1081%)
Cash: $4,202 (1179% of Medicare)
Ins. Median: $3,853 (1081% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1081% of the Medicare baseline (a markup of 981%). 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
UnitedHealthcare $344 - $5,389 97%
Amerihealth Caritas $373 105%
Geisinger $373 - $4,248 105%
Upmc Health Plan $373 - $2,764 105%
Highmark Wholecare (Prev Gateway) $378 - $1,268 106%
Health Partners Plans (Jefferson Health Plan) $511 143%
Pa Health & Wellness $578 - $1,369 162%
Aetna $1,035 - $5,471 290%
Blue Cross Blue Shield $1,150 - $3,206 323%
Cigna $1,208 - $1,331 339%
Upmc Work Partners $2,380 668%
Wirerope Works $3,197 - $3,525 897%
Multiplan $4,485 - $6,023 1258%
America'S Choice $5,175 - $5,706 1452%
Intergroup $5,175 - $5,706 1452%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 32-36 Central Avenue, Wellsboro, PA 16901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals