CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Upland Hills Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,700
Cash Discount Price: $1,939
vs. Medicare Baseline: 4.77x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Upland Hills Health is $1,700. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,939. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.77x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$1,939

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,700

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: $1,939 (544%)

Insurance Median: $1,700 (477%)

Cash: $1,939 (544% of Medicare)

Ins. Median: $1,700 (477% 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 477% of the Medicare baseline (a markup of 377%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Dean Health Plan	$192 - $4,222	54%
UnitedHealthcare	$215 - $1,848	60%
Alliance	$263 - $3,432	74%
Ghc Of Eau Claire	$539	151%
Ghc Of Sc Wi	$539 - $4,128	151%
Mhs	$539 - $1,700	151%
Medical Associates	$1,281 - $1,700	359%
Blue Cross Blue Shield	$1,700 - $4,978	477%
Humana	$1,700 - $5,463	477%
Icare	$1,700	477%
Security Health Plan	$1,700	477%
Quartz	$2,870	805%
Wps	$3,703 - $3,818	1039%
Cigna	$4,528 - $5,063	1270%
Multiplan	$5,342	1499%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,939.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Upland Hills Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.