CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Bella Vista Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $279
Cash Discount Price: $850
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Bella Vista Hospital is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $850. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.78x the Medicare baseline. Located in Carr 349 Km 2 7 Cerro Las Mesas, Mayaguez, PR.

Cash / Self-Pay

$850

Average discount available for prompt cash payment at this facility.

Insurance Median

$279

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: $850 (238%)

Insurance Median: $279 (78%)

Cash: $850 (238% of Medicare)

Ins. Median: $279 (78% 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
First Medical Vital	$179	50%
Medicare (plans)	$194 - $265	54%
Plan Salud Menonita Vital	$199	56%
Asociacion Maestros (Prossam)	$250	70%
Triple S Vital	$262	74%
Preferred Medical Choice(Pmc)	$265	74%
Mcs	$271	76%
Triple S Advantage	$279	78%
Champva	$287	81%
Tricare	$287	81%
UnitedHealthcare	$287	81%
International Medical Card	$312	88%
Mapfre Life Insurance Life Insurance	$325	91%
Triple S	$325	91%
Servicios De Salud Bella Vista	$650	182%
Plan Salud Menonita	$657	184%

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 $850.
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 Bella Vista Hospital 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.