CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Oakleaf Surgical Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $236
  • Cash Discount Price: $2,005
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Oakleaf Surgical Hospital is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,005. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$2,005

Average discount available for prompt cash payment at this facility.

Insurance Median
$236

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: $2,005 (822%)
Insurance Median: $236 (97%)
Cash: $2,005 (822% of Medicare)
Ins. Median: $236 (97% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $236 - $3,220 97%
Dean Health Plan $236 97%
Group Health Cooperative Of Eau Claire $236 97%
Healthpartners $236 97%
Humana $236 97%
Medica $236 97%
Quartz Health Solutions $236 97%
Security Health Plan Of Wi $236 - $876 97%
Ucare Wi $236 97%
UnitedHealthcare $236 97%
Alliance $1,182 485%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital in Altoona, Wisconsin, reports a cash median price of $2,005 for an MRI of the brain (no contrast), which is significantly lower than the facility's gross charge of $2,228 and the Medicare benchmark rate of $243.77. While the hospital's cash rate is higher than the average Medicare reimbursement, it remains the lowest price point available for this procedure among the 11 payers listed, with negotiated rates ranging from $236 to $3,220 depending on the insurance plan. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $2,005 upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible is not satisfied.

It is important to note that the cash rate of $2,005 is substantially lower than the highest negotiated rates observed, such as the $3,220 maximum for Blue Cross Blue Shield, and avoids the administrative markups often associated with commercial billing cycles. To potentially lower this cost further, patients should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% when paid in full within a short window. Additionally, patients should request an itemized billing audit before finalizing payment to ensure there are no errors, unbundled codes, or services not rendered, as over 80% of hospital bills typically contain discrepancies that can be corrected to reduce the total amount owed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals