CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Southwestern Vermont Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $365
Cash Discount Price: $1,654
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Southwestern Vermont Medical Center is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,654. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.02x the Medicare baseline. Located in 100 Hospital Drive, Bennington, VT.

Cash / Self-Pay

$1,654

Average discount available for prompt cash payment at this facility.

Insurance Median

$365

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: $1,654 (464%)

Insurance Median: $365 (102%)

Cash: $1,654 (464% of Medicare)

Ins. Median: $365 (102% 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
Cdphp	$73 - $675	20%
Aetna	$101 - $912	28%
Blue Cross Blue Shield	$101 - $365	28%
Cigna	$101 - $520	28%
Fidelis	$101 - $383	28%
Hne	$101 - $465	28%
Humana	$101 - $365	28%
Mvp	$101 - $625	28%
UnitedHealthcare	$101 - $530	28%
Wellcare	$101 - $365	28%
Health New England	$118	33%
Allegiance	$141	40%
Bmc	$465	130%
Tufts	$1,140	320%

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 $1,654.
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 Southwestern Vermont 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.