CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lafollette Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $424
  • Cash Discount Price: $2,833
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lafollette Medical Center is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,833. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.19x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$2,833

Average discount available for prompt cash payment at this facility.

Insurance Median
$424

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: $2,833 (795%)
Insurance Median: $424 (119%)
Cash: $2,833 (795% of Medicare)
Ins. Median: $424 (119% 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.

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
Medicaid / KanCare $159 - $774 45%
UnitedHealthcare $159 - $9,444 45%
Tricare $309 87%
Veterans Eval Services $319 89%
Node Champva $325 91%
Triwest $332 93%
Blue Cross Blue Shield $334 - $1,643 94%
Humana $334 - $2,078 94%
Medicare (plans) $334 94%
Node Bluecare Plus Tn Mcr Adv $334 94%
Node Hospice Non Par Agree $339 95%
Node Va $339 95%
Node Wellcare Mcr Adv $339 95%
Node Devoted Health Mcr Adv $340 95%
Node Farm Bureau Mcr Adv $340 95%
Aetna $344 - $5,874 97%
Node Blueadvantage Mcr Adv $344 97%
Node Healthspring Mcr Adv $344 97%
Node Amerigroup Mcr Adv $350 98%
Windsor Health Plan $350 98%
Amerigroup $355 100%
Node Nhc Mcr Adv $367 103%
Node Us Dept Of Labor $424 119%
Cigna $469 132%
Novanet Work Comp Tn $530 149%
Tn Work Comp $536 150%
Ambetter / Centene $627 176%
Node Point Comfort Underwriters $746 209%
Bluecare $764 - $863 214%
Wellcare $774 217%
Self Pay $2,711 761%
Multiplan Complementary $7,177 2014%
Beech Street Work Comp Tn $52,930 14850%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals