CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Oakleaf Surgical Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $346
  • Cash Discount Price: $3,262
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Oakleaf Surgical Hospital is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,262. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$3,262

Average discount available for prompt cash payment at this facility.

Insurance Median
$346

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: $3,262 (915%)
Insurance Median: $346 (97%)
Cash: $3,262 (915% of Medicare)
Ins. Median: $346 (97% 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.

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 $346 - $3,220 97%
Dean Health Plan $346 97%
Group Health Cooperative Of Eau Claire $346 97%
Healthpartners $346 97%
Humana $346 97%
Medica $346 97%
Quartz Health Solutions $346 97%
Security Health Plan Of Wi $346 - $876 97%
Ucare Wi $346 97%
UnitedHealthcare $346 97%
Alliance $1,728 485%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital, located at 1000 Oakleaf Way in Altoona, Wisconsin, reports a cash median price of $3,262 for the MRI, brain (with and without contrast) procedure (CPT 70553), based on the 2026-06 vintage data. While the facility's gross charge is $3,624, the cash median remains significantly lower than the listed gross amount. For patients with high-deductible plans, paying the cash price of $3,262 upfront may be more cost-effective than relying on insurance coverage, particularly given that the negotiated rate for Blue Cross Blue Shield is $3,460 and the allowed amount for Alliance is $1,728. It is advisable to contact the hospital directly to inquire about potential "self-pay" or "prompt-pay" discounts, which could further reduce the final bill.

Regarding insurance coverage, the facility has contracts with 11 different payers, with negotiated rates ranging from a low of $346 to a high of $3,220 depending on the specific plan. The median negotiated rate across all payers is $346, which is notably lower than the cash price, though this rate often represents the insurer's allowed amount rather than the final patient responsibility. The Medicare amount for this service is $356.43, which serves as a benchmark for evaluating the facility's pricing structure. Patients should be aware that while some payers like Alliance have a fixed rate of $1,728, others such as Dean Health Plan, Healthpartners, and UnitedHealthcare have a consistent rate of $346.

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