CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Holy Cross Hospital-Davis

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,103
Cash Discount Price: $2,438
vs. Medicare Baseline: 8.71x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Holy Cross Hospital-Davis is $3,103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,438. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.71x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.

Cash / Self-Pay

$2,438

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,103

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: $2,438 (684%)

Insurance Median: $3,103 (871%)

Cash: $2,438 (684% of Medicare)

Ins. Median: $3,103 (871% 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 871% of the Medicare baseline (a markup of 771%). 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
Select Health	$131 - $2,996	37%
Medicaid / KanCare	$166	47%
Uuhp	$166 - $1,669	47%
Humana	$191	54%
Medicare (plans)	$191	54%
Employer Direct Healthcare	$240	67%
Motivhealth	$254	71%
Blue Cross Blue Shield	$366 - $3,657	103%
Molina	$449 - $2,617	126%
Cigna	$490 - $4,876	137%
Centura Employee Plan	$543	152%
Pehp	$2,356 - $3,535	661%
Aetna	$2,693 - $5,151	756%
Wise	$3,170 - $3,231	889%
Deseret Mutual Benefit Administrators	$3,743	1050%
Multiplan	$4,206 - $5,547	1180%
UnitedHealthcare	$4,419 - $6,095	1240%
Emi Health	$5,303	1488%

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 $2,438.
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 Holy Cross Hospital-Davis 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.