CMS Price Transparency Data

MRI, brain (no contrast)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,422
Cash Discount Price: $3,092
vs. Medicare Baseline: 9.94x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at UPMC Children's Hospital of Pittsburgh is $2,422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,092. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.94x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$3,092

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,422

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: $3,092 (1268%)

Insurance Median: $2,422 (994%)

Cash: $3,092 (1268% of Medicare)

Ins. Median: $2,422 (994% 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 994% of the Medicare baseline (a markup of 894%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$222 - $2,834	91%
Health Plan Of Upper Ohio Valley	$230 - $3,349	94%
Blue Cross Blue Shield	$245 - $2,576	101%
Amerihealth Caritas	$249 - $1,264	102%
Cigna	$249 - $2,834	102%
Upmc Health Plan	$779 - $2,235	320%
UnitedHealthcare	$1,068 - $2,422	438%
Health Partners Plans (Jefferson Health Plan)	$1,307	536%
Highmark Wholecare (Prev Gateway)	$1,362	559%
Pa Health & Wellness	$1,368	561%
Geisinger	$1,388 - $2,316	569%
Intergroup	$3,349 - $4,380	1374%
Coventry/First Health	$4,122	1691%
Saudi Armed Forces	$4,122	1691%
Health Payors Organization	$4,380	1797%
Multiplan	$4,380	1797%
National Provider Network	$4,638	1903%
Private Health Care Systems	$4,638	1903%

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 $3,092.
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 Children's Hospital of Pittsburgh 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.