CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Porter Hospital Inc

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $488
Cash Discount Price: $2,787
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Porter Hospital Inc is $488. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,787. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.37x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$2,787

Average discount available for prompt cash payment at this facility.

Insurance Median

$488

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: $2,787 (782%)

Insurance Median: $488 (137%)

Cash: $2,787 (782% of Medicare)

Ins. Median: $488 (137% 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
UnitedHealthcare	$72 - $4,957	20%
Mvp	$87 - $4,667	24%
Fidelis Care	$92 - $2,118	26%
Humana	$97 - $339	27%
Capital District Physicians' Health Plan	$102 - $4,176	29%
Aetna	$103 - $2,353	29%
Martins Point	$103 - $2,353	29%
Veterans Affairs Community Care Network	$103 - $2,353	29%
Veterans Choice	$103 - $2,353	29%
Blue Cross Blue Shield	$118 - $4,718	33%
Harvard Pilgrim	$120 - $4,006	34%
Coventry	$133 - $4,406	37%
Cigna	$148 - $4,554	42%
Wellpath	$312 - $2,754	88%
Medical Corporation	$539 - $4,757	151%
Multiplan	$539 - $4,757	151%

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 $2,787.
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 Porter Hospital Inc 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.