CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Forks Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,110
Cash Discount Price: $5,153
vs. Medicare Baseline: 8.73x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Forks Community Hospital is $3,110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,153. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.73x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$5,153

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,110

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: $5,153 (1446%)

Insurance Median: $3,110 (873%)

Cash: $5,153 (1446% of Medicare)

Ins. Median: $3,110 (873% 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 873% of the Medicare baseline (a markup of 773%). 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
Medicare (plans)	$318	89%
Medicaid / KanCare	$2,065 - $2,533	579%
Coordinated Care (Mco) Mcd-All Plans	$2,230 - $2,581	626%
UnitedHealthcare	$2,658 - $5,874	746%
Community Health Network Mcr-All Other Plans	$2,687 - $3,110	754%
Humana	$2,687 - $3,110	754%
Tricare	$2,687 - $3,110	754%
Triwest-All Plans	$2,687 - $3,110	754%
Ambetter / Centene	$3,117 - $3,608	875%
Wellcare Med Adv - All Plans	$3,117 - $3,608	875%
Regence-All Other Plans	$3,438 - $3,979	965%
Community Health Exchange	$3,881 - $4,492	1089%
Molina Commercial-All Other Plans	$5,493 - $6,358	1541%
Aetna	$5,672 - $6,565	1591%
Blue Cross Blue Shield	$5,672 - $6,565	1591%
Cigna	$5,971 - $6,911	1675%
First Choice-All Plans	$5,971 - $6,911	1675%

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 $5,153.
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 Forks Community Hospital 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.