CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Johnson City Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $527
Cash Discount Price: $669
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Johnson City Medical Center is $527. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $669. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.48x the Medicare baseline. Located in 400 N State of Franklin Rd, Johnson City, TN.

Cash / Self-Pay

$669

Average discount available for prompt cash payment at this facility.

Insurance Median

$527

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: $669 (188%)

Insurance Median: $527 (148%)

Cash: $669 (188% of Medicare)

Ins. Median: $527 (148% 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.

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
Aetna	$326 - $2,844	91%
Amerigroup	$326 - $433	91%
Humana	$326	91%
Managed Medicaire	$326	91%
Medicare (plans)	$326	91%
Mountain Empire Pace	$326	91%
Sentara Health	$326 - $1,555	91%
United Mine Workers Of America	$326	91%
UnitedHealthcare	$326 - $4,346	91%
Blue Cross Blue Shield	$335 - $1,510	94%
Molina Healthcare	$339 - $532	95%
Cigna	$342 - $1,025	96%
Devoted Health Plan	$342	96%
Nhc Advantage	$342	96%
Wellcare	$345 - $4,457	97%
Optima Health	$511	143%
Ambetter / Centene	$710	199%
Medcost	$1,560	438%
First Health Coventry	$3,343	938%
Seven Corners, Inc.	$4,457	1250%

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 $669.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Johnson City Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
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.