CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Sheridan Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $617
Cash Discount Price: $519
vs. Medicare Baseline: 1.73x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Sheridan Memorial Hospital is $617. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $519. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.73x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$519

Average discount available for prompt cash payment at this facility.

Insurance Median

$617

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: $519 (146%)

Insurance Median: $617 (173%)

Cash: $519 (146% of Medicare)

Ins. Median: $617 (173% 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.

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
Blue Cross Blue Shield	$80 - $2,179	22%
Humana	$104 - $382	29%
Pacificsource-All Plans	$107 - $2,310	30%
Wise Provider Network-All Plans	$107 - $2,441	30%
Medi-Share Profee Only - All Plans	$110 - $584	31%
Miscellaneous-All Plans	$110 - $2,362	31%
Cigna	$113 - $2,441	32%
First Choice Comm - All Plans	$116 - $2,494	33%
Phcs Multiplan-All Plans	$116 - $2,494	33%
Three Rivers-All Plans	$116 - $2,494	33%
Wy School Boards-All Plans	$2,192	615%
UnitedHealthcare	$2,250	631%
C1 Employee - All Plans	$2,362	663%
Casper Opco Llc - All Plans	$2,362	663%
First Health Comm - All Plans	$2,362	663%
Ebms - All Plans	$2,494	700%

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 $519.
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 Sheridan Memorial Hospital 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.