CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Primary Children's Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $2,071
  • Cash Discount Price: $2,187
  • vs. Medicare Baseline: 5.81x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Primary Children's Hospital is $2,071. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,187. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.81x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$2,187

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,071

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: $2,187 (614%)
Insurance Median: $2,071 (581%)
Cash: $2,187 (614% of Medicare)
Ins. Median: $2,071 (581% 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 581% of the Medicare baseline (a markup of 481%). 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
American Health $107 - $1,662 30%
Health Plan Of Nevada $107 - $211 30%
Healthy U $107 - $211 30%
Molina $107 - $2,450 30%
Selecthealth $107 - $2,450 30%
Southwest Behavioral Health $107 - $350 30%
UnitedHealthcare $107 - $2,450 30%
Tricare $342 96%
Triwest $342 96%
Donor Connect $1,050 - $1,161 295%
Aetna $2,071 - $2,479 581%
Awh Connected $2,071 - $2,479 581%
Byu Athletics $2,071 - $2,450 581%
Campbell Scientific $2,071 - $2,450 581%
Cigna $2,071 - $2,450 581%
Deseret Mutual $2,071 - $2,450 581%
Emi $2,071 - $2,450 581%
Emi Health $2,071 - $2,450 581%
First Choice $2,071 - $2,450 581%
First Choice Of The Midwest $2,071 - $2,450 581%
Franklin County $2,071 - $2,450 581%
Global Excel $2,071 - $2,450 581%
Health Utah $2,071 - $2,450 581%
Humana $2,071 - $2,450 581%
Hygeia Corporation $2,071 - $2,450 581%
Ifit $2,071 - $2,450 581%
Juniper Systems $2,071 - $2,450 581%
Lw Miller $2,071 - $2,450 581%
Managed Care Admin $2,071 - $2,450 581%
Medcare International $2,071 - $2,450 581%
Motivhealth $2,071 - $2,450 581%
Pehp $2,071 - $2,450 581%
Prodegi Corp Benefit $2,071 - $2,450 581%
Tanner Llc $2,071 - $2,450 581%
Uofu $2,071 - $2,450 581%
Utah Tech $2,071 - $2,450 581%
Wise Network $2,071 - $2,450 581%
First Health $2,100 - $2,479 589%
Blue Cross Blue Shield $2,129 - $2,508 597%
Springtide $2,129 - $2,508 597%
Utah Behavioral Health Network $2,362 663%
Altius Mhnet Behavioral Health $2,567 720%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens