CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Black River Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $2,085
  • Cash Discount Price: $5,619
  • vs. Medicare Baseline: 5.85x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Black River Memorial Hospital is $2,085. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,619. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.85x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.
Cash / Self-Pay
$5,619

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,085

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: $5,619 (1576%)
Insurance Median: $2,085 (585%)
Cash: $5,619 (1576% of Medicare)
Ins. Median: $2,085 (585% 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 585% of the Medicare baseline (a markup of 485%). 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
Humana $101 - $5,806 28%
UnitedHealthcare $101 - $5,887 28%
Blue Cross Blue Shield $106 - $3,184 30%
Group Health Cooperative Of Eau Claire $106 - $6,056 30%
My Choice Wisconsin, Inc. $106 - $3,184 30%
Quartz Health Solutions, Inc $106 - $5,681 30%
Corvel $1,339 - $3,808 376%
Security Health Plan $1,838 - $5,831 516%
The Alliance $1,866 - $5,993 524%
Triology Health Solutions $1,976 - $5,931 554%
Medica $2,050 - $5,831 575%
Association Benefits Solution $2,085 - $5,931 585%
Family Health Center Of Marshfield $2,085 - $5,931 585%
First Health Group Corporation $2,085 - $5,931 585%
Provider Network Of America $2,085 - $5,931 585%
Cigna $2,129 - $6,056 597%
Cofinity $2,129 - $6,056 597%
Coventry Health Care $2,129 - $6,056 597%
Custom Benefit Administrators $2,129 - $6,056 597%
Healthpartners, Inc. $2,129 - $6,056 597%
Multiplan $2,129 - $6,181 597%
Wisconsin Physicians Service Insurance Corp $2,129 - $6,056 597%
Chorus $2,151 - $6,118 603%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 711 W Adams St, Black River Falls, WI 54615
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals