CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Aurora Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,352
  • Cash Discount Price: $3,265
  • vs. Medicare Baseline: 3.79x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Aurora Medical Center is $1,352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,265. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.79x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.
Cash / Self-Pay
$3,265

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
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $3,265 (916%)
Insurance Median: $1,352 (379%)
Cash: $3,265 (916% of Medicare)
Ins. Median: $1,352 (379% 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 379% of the Medicare baseline (a markup of 279%). 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 $650 182%
Blue Cross Blue Shield $755 - $5,550 212%
UnitedHealthcare $767 - $5,498 215%
Healthpartners $954 - $4,898 268%
Centivo $1,038 291%
Common Ground $1,083 304%
Aetna $1,114 - $5,394 313%
Health Payment Systems $1,170 328%
Quartz One $1,200 337%
Molina Exchange $1,273 357%
Hs Technology $1,350 379%
Quartz Group $1,350 379%
Everpointe Elite $1,352 379%
Trilogy $1,520 426%
Wisconsin Physician Service $1,636 - $1,722 459%
Cigna $2,550 - $5,524 715%
Health Eos Plus $3,918 1099%
Health Eos $5,224 1466%

Consumer Guidance & Cost Commentary

If you are paying out of pocket, you should know that the cash median rate for this MRI procedure is $3,265, which is significantly lower than the facility's gross charge of $6,530. While many patients assume insurance will always be cheaper, this cash rate can actually be more affordable if your insurance plan has a high deductible or if the negotiated rate from your specific carrier exceeds $3,265. Before scheduling, it is crucial to ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed by offering immediate liquidity incentives that bypass standard claims processing fees.

The broader pricing context reveals that while the cash rate is competitive, the negotiated rates vary widely depending on your insurance carrier. For instance, Blue Cross Blue Shield has a high-end negotiated rate of $5,550, whereas UnitedHealthcare's range extends up to $5,498, both of which are substantially higher than the cash price. In contrast, payers like Centivo, Common Ground, and several others have fixed negotiated rates around $1,038 to $1,352, which align closely with or fall below the cash median. Additionally, the Medicare amount for this service is $356.43, serving as a benchmark that highlights the significant markup present in commercial rates, with some negotiated plans reaching amounts nearly 19 times the Medicare base.

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