CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Prisma Health Laurens County Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $829
  • Cash Discount Price: $2,913
  • vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Prisma Health Laurens County Hospital is $829. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,913. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.33x the Medicare baseline. Located in 22725 Highway 76 East, Clinton, SC.
Cash / Self-Pay
$2,913

Average discount available for prompt cash payment at this facility.

Insurance Median
$829

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: $2,913 (817%)
Insurance Median: $829 (233%)
Cash: $2,913 (817% of Medicare)
Ins. Median: $829 (233% 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 233% of the Medicare baseline (a markup of 133%). 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
Medicare (plans) $196 - $2,888 55%
Tricare $332 93%
Blue Cross Blue Shield $354 - $3,023 99%
Champva [3049] $354 99%
Cigna $354 - $2,688 99%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $354 99%
Deseret Mutual Ins Co [3066] $354 99%
Generic Skilled Nursing [3196] $354 99%
Hospice Contracted [1500] $354 99%
Hospice Non Contracted [3190] $354 99%
Triwest Healthcare Alliance Vcp [902] $354 99%
Va Community Care Network-Vaccn [903] $354 99%
Veterans Administration [3194] $354 99%
Humana $361 - $3,090 101%
UnitedHealthcare $367 - $829 103%
Aetna $372 - $3,540 104%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $372 104%
Healthy Conn Prime-First Choice Vip Care [5300] $376 105%
Healthy Conn Prime-Molina Healthcare [5330] $390 109%
Workers Comp [600] $496 139%
Ambetter / Centene $652 183%
Medicaid / KanCare $690 - $3,032 194%
Golden Rule Insurance Company [2991] $829 233%
Oxford Health Plans [2992] $829 233%
Zzumr-Salt Lake City Ut [3169] $829 233%
Bluechoice [810] $1,022 - $3,185 287%
Prisma Health Seniorcare Pace - Midlands [5400] $1,040 292%
Prisma Health Seniorcare Pace-Upstate [5200] $1,040 292%
Sc Dept Of Corrections [2998] $1,132 318%
Scdc-Sc Dept Of Corrections [7232] $1,132 318%
Promise Health Plan Contracted [2401] $1,568 - $2,150 440%
Bob Jones Univ-Pai [821] $1,616 453%
Orangeburg Senior Helping Center Pace [5401] $1,792 503%
Evernorth Behavioral Contracted [2982] $2,688 754%
Mvp Health Care [3037] $2,688 754%
Meritain Health Contracted [2200] $2,868 - $3,540 805%
First Choice Benefits Mgmt [3074] $2,888 810%
Planned Administrators [820] $3,023 848%
Preferred Administrators Contracted [2839] $3,137 880%
Medcost [2940] $3,316 - $3,719 930%
Atlantic Packaging Contracted [4833] $3,361 943%
Aps Healthcare System [2981] $3,585 1006%
Multiplan/Phcs Contracted [2950] $3,988 1119%
Vsp Vision Care [2986] $4,033 1131%
First Health Contracted [2952] $4,167 1169%
Furman Int/Allen University Student [2951] $4,167 1169%
Quiktrip-First Health [3067] $4,167 1169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22725 Highway 76 East, Clinton, SC 29325
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals