CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Aurora Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,352
  • Cash Discount Price: $2,110
  • vs. Medicare Baseline: 5.55x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Aurora Medical Center is $1,352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,110. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.55x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.
Cash / Self-Pay
$2,110

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,352

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: $2,110 (866%)
Insurance Median: $1,352 (555%)
Cash: $2,110 (866% of Medicare)
Ins. Median: $1,352 (555% 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 555% of the Medicare baseline (a markup of 455%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aurora Caregiver $650 267%
Blue Cross Blue Shield $755 - $3,587 310%
UnitedHealthcare $767 - $3,553 315%
Healthpartners $954 - $3,165 391%
Centivo $1,038 426%
Common Ground $1,083 444%
Aetna $1,114 - $3,486 457%
Health Payment Systems $1,170 480%
Quartz One $1,200 492%
Molina Exchange $1,273 522%
Hs Technology $1,350 554%
Quartz Group $1,350 554%
Everpointe Elite $1,352 555%
Trilogy $1,520 624%
Wisconsin Physician Service $1,636 - $1,722 671%
Health Eos Plus $2,532 1039%
Cigna $2,550 - $3,570 1046%
Health Eos $3,376 1385%

Consumer Guidance & Cost Commentary

For patients paying cash directly, the most important fact to know is that the cash median rate for this MRI, brain (no contrast) procedure is $2,110. While this amount is higher than the facility's negotiated rates of $1,352 and $969, it is worth noting that cash payments can sometimes be more cost-effective than insurance billing for those with high-deductible plans, as the insurer's negotiated rate may exceed the cash price. Furthermore, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final bill by bypassing the administrative costs associated with insurance claims processing.

The broader pricing context reveals that this service is billed at a gross rate of $4,220, with an average Medicare reimbursement of $243.77, indicating a significant markup typical of commercial billing. The facility, Aurora Medical Center in Grafton, WI, reports a facility rating of 5 stars and has contracted with 18 different payers. While the data provided does not include specific comparative averages for the state or county, the presence of multiple payers with varying negotiated ranges—such as Blue Cross Blue Shield ranging from $755 to $3,587 and Cigna ranging from $2,550 to $3,570—highlights that final costs depend heavily on individual insurance contracts rather than a single fixed price.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 Port Washington Road, Grafton, WI 53024
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals