CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sanford Vermillion Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,568
Cash Discount Price: $2,914
vs. Medicare Baseline: 10.53x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sanford Vermillion Medical Center is $2,568. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,914. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.53x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.

Cash / Self-Pay

$2,914

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,568

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: $2,914 (1195%)

Insurance Median: $2,568 (1053%)

Cash: $2,914 (1195% of Medicare)

Ins. Median: $2,568 (1053% 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 1053% of the Medicare baseline (a markup of 953%). 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
Sanford Health Plan Align	$1,074	441%
Wellmark Sd	$1,107	454%
Ucare	$1,187 - $3,200	487%
Aetna	$1,202 - $3,165	493%
Health Partners	$1,202 - $2,732	493%
Medicare (plans)	$1,202	493%
UnitedHealthcare	$1,202 - $3,041	493%
Primewest	$1,224	502%
Sanford Health Plan	$1,442 - $1,934	592%
Security Health Plan	$2,003	822%
Medica	$3,005 - $3,212	1233%
Wellmark	$3,132 - $3,169	1285%
First Choice Health Network	$3,278	1345%
Healthez	$3,278	1345%
Multiplan	$3,278	1345%

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 $2,914.
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 Vermillion 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.