CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Highpoint Health-Sumner With Ascension Saint Thoma

Billing Code: 70553 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$737

about 2.1× the $356 Medicare rate · typically $369–$900

modeled estimate · not a bill or quote

What this hospital charges insurers

$519

Below the fair price — a good deal

about $218 under the fair price · 1.5× Medicare

Medicare pays $356 Fair price $737 This hospital $519 Cash price $2,773 Hospital's list price $11,902

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $101 Priciest $519

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, brain (with and without contrast) is about $737 (about 2.1× the $356 Medicare rate). Highpoint Health-Sumner With Ascension Saint Thoma charges insurers about $519, or about $2,773 in cash — below the fair price — a good deal. Located in Gallatin, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna AetnaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$828	232%
Blue Cross Blue Shieldmajor	$519 - $563	146%
Cignamajor	$493	138%
Health Net	$520	146%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,773), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 70553.

Insurance Before you use insurance

Call your insurance company to confirm Highpoint Health-Sumner With Ascension Saint Thoma is in-network.
Ask your insurer whether prior approval is required for CPT code 70553.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Highpoint Health-Sumner With Ascension Saint Thoma

Compare: MRI, brain (with and without contrast) at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.