CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Astria Sunnyside Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $966
Cash Discount Price: $1,342
vs. Medicare Baseline: 2.71x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Astria Sunnyside Hospital is $966. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,342. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.71x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$1,342

Average discount available for prompt cash payment at this facility.

Insurance Median

$966

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: $1,342 (377%)

Insurance Median: $966 (271%)

Cash: $1,342 (377% of Medicare)

Ins. Median: $966 (271% 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 271% of the Medicare baseline (a markup of 171%). 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)	$387 - $595	109%
Medicaid / KanCare	$450 - $722	126%
Aetna	$578 - $2,072	162%
Healthcomp_Ihs	$578	162%
Humana	$578 - $2,120	162%
Molina	$578	162%
Va	$578	162%
Tricare	$583	164%
Regence	$1,210	339%
Cigna	$1,413	396%
Li	$1,446	406%
First_Choice	$1,766	495%
Tpsc	$1,837	515%
Kaiser	$1,849	519%
Premera	$1,917	538%
UnitedHealthcare	$2,002	562%
Fhpw	$2,072	581%
Healthcomp	$2,120	595%
Bcchp	$2,355	661%
Great_Rivers	$2,355	661%
Zenith	$2,355	661%

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 $1,342.
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 Astria Sunnyside 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.