CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Freestone Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $2,231
  • Cash Discount Price: $5,592
  • vs. Medicare Baseline: 6.26x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Freestone Medical Center is $2,231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,592. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.26x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
$5,592

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,231

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: $5,592 (1569%)
Insurance Median: $2,231 (626%)
Cash: $5,592 (1569% of Medicare)
Ins. Median: $2,231 (626% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 626% of the Medicare baseline (a markup of 526%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $164 - $5,193 46%
Gilsbar $339 - $7,989 95%
Mcaid $464 - $1,678 130%
Misc Mcaid Hmo $464 - $2,397 130%
Superior Health Chip $464 - $1,678 130%
Tx Childrens Mcaid $464 - $1,678 130%
UnitedHealthcare $464 - $2,397 130%
Amerigroup $552 - $2,397 155%
Medicaid / KanCare $552 - $3,691 155%
Rightcare S&W Mcaid $552 - $2,397 155%
Superior Health Mcd $552 - $3,691 155%
Aarp $667 187%
Apwu $667 187%
Fringe Benefits $667 187%
Geha $667 187%
Uhcss $667 187%
Aetna $1,302 - $6,391 365%
Cigna $4,793 1345%
Misc Multiplan $5,592 1569%
Misc Multiplan Auto $5,592 1569%
Misc Multiplan Workcomp $5,592 1569%
Self Pay Gt 083123 $5,592 1569%
Self Pay Lt 090123 $5,592 1569%
Aflac $7,989 2241%
Bankers Life $7,989 2241%
Fairview Nursing Home $7,989 2241%
Humana $7,989 2241%
Icare $7,989 2241%
Inmate Freestone Co $7,989 2241%
Misc Hospice $7,989 2241%
Miscellaneous $7,989 2241%
Miscellaneous Auto $7,989 2241%
Mutual Of Omaha $7,989 2241%
North American Med Empl $7,989 2241%
Standard Life Insurance $7,989 2241%
Tml $7,989 2241%
Zelis Healthcare $7,989 2241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals