CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,012
  • Cash Discount Price: $1,949
  • vs. Medicare Baseline: 8.45x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Childrens Hospital of Wisconsin Fox Valley is $3,012. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,949. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.45x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$1,949

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,012

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: $1,949 (547%)
Insurance Median: $3,012 (845%)
Cash: $1,949 (547% of Medicare)
Ins. Median: $3,012 (845% 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 845% of the Medicare baseline (a markup of 745%). 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
Froedtert Health $2,481 - $3,012 696%
Medical College Of Wisconsin $2,481 696%
Network Health Plan $2,523 708%
UnitedHealthcare $2,605 731%
Aspirus Health Plan $2,658 746%
Common Ground Healthcare Cooperative $2,658 - $3,012 746%
Trilogy Health Solutions $2,658 - $3,012 746%
Wps Health Plan $2,693 - $3,190 756%
Advocate Aurora Healthcare $2,729 766%
Blue Cross Blue Shield $2,764 - $3,367 775%
Centivo $2,764 775%
Health Partners $2,764 - $3,119 775%
Employer Health Care Alliance Cooperative $2,782 781%
Dean Health Plan $2,835 795%
Group Health Cooperative Of Eau Claire $2,835 795%
Oan Llc $2,835 795%
Security Health Plan $2,942 825%
Health Payment Systems $2,998 841%
Praire States $3,012 845%
Quartz Health Insurance $3,012 845%
Sheboygan Employer'S Health Network $3,012 845%
America'S Ppo $3,083 865%
Aetna $3,119 - $3,154 875%
Bellin Thedacare $3,190 895%
Cigna $3,190 895%
Group Health Cooperative Of South Central Wisconsin $3,190 895%
Healthsmart $3,190 895%
Prevea Health Network $3,190 895%
Multiplan $3,225 - $3,367 905%
Coventry Health Care $3,367 945%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Second St, Neenah, WI 54956
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens