CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Astria Sunnyside Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,248
Cash Discount Price: $1,734
vs. Medicare Baseline: 5.12x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Astria Sunnyside Hospital is $1,248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,734. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.12x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$1,734

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,248

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,734 (711%)

Insurance Median: $1,248 (512%)

Cash: $1,734 (711% of Medicare)

Ins. Median: $1,248 (512% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 512% of the Medicare baseline (a markup of 412%). 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)	$238 - $768	98%
Medicaid / KanCare	$581 - $932	238%
Aetna	$746 - $2,677	306%
Healthcomp_Ihs	$746	306%
Humana	$746 - $2,738	306%
Molina	$746	306%
Va	$746	306%
Tricare	$754	309%
Regence	$1,564	642%
Cigna	$1,825	749%
Li	$1,868	766%
First_Choice	$2,282	936%
Tpsc	$2,373	973%
Kaiser	$2,389	980%
Premera	$2,476	1016%
UnitedHealthcare	$2,586	1061%
Fhpw	$2,677	1098%
Healthcomp	$2,738	1123%
Bcchp	$3,042	1248%
Great_Rivers	$3,042	1248%
Zenith	$3,042	1248%

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 $1,734.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Astria Sunnyside Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.