CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sanford Usd Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,424
Cash Discount Price: $3,142
vs. Medicare Baseline: 5.84x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sanford Usd Medical Center is $1,424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,142. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.84x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.

Cash / Self-Pay

$3,142

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,424

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: $3,142 (1289%)

Insurance Median: $1,424 (584%)

Cash: $3,142 (1289% of Medicare)

Ins. Median: $1,424 (584% 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 584% of the Medicare baseline (a markup of 484%). 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
Blue Cross Blue Shield	$109 - $308	45%
Sanford Health Plan	$201	82%
Sanford Health Plan Align	$230	94%
Ucare	$247 - $2,760	101%
Aetna	$249 - $3,004	102%
Health Partners	$249 - $1,532	102%
Medicare (plans)	$249	102%
UnitedHealthcare	$249 - $3,460	102%
Primewest	$254 - $257	104%
Security Health Plan	$2,160	886%
Medica	$2,647 - $2,831	1086%
First Choice Health Network	$3,534	1450%
Healthez	$3,534	1450%
Multiplan	$3,534	1450%

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 $3,142.
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 Sanford Usd Medical Center 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.