CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Christopher's Hospital for Children

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,146
Cash Discount Price: $7,567
vs. Medicare Baseline: 6.02x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Christopher's Hospital for Children is $2,146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,567. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.02x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.

Cash / Self-Pay

$7,567

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,146

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: $7,567 (2123%)

Insurance Median: $2,146 (602%)

Cash: $7,567 (2123% of Medicare)

Ins. Median: $2,146 (602% 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 602% of the Medicare baseline (a markup of 502%). 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
Geisinger	$328 - $6,810	92%
Amerihealth Caritas	$336	94%
Pa Health & Wellness	$363	102%
Health Partners	$379 - $3,396	106%
UnitedHealthcare	$404 - $586	113%
Aetna	$471 - $11,350	132%
Upmc	$484	136%
Keystone First	$508	143%
Cigna	$526	148%
Gateway	$597	167%
Horizon Nj Health	$1,110	311%
Blue Cross Blue Shield	$1,372 - $8,207	385%
Wellpoint Nj (Formerly Amerigroup)	$4,010	1125%

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 $7,567.
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 Christopher's Hospital for Children 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.