CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Memorial Hospital of Carbon County

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,993
Cash Discount Price: $1,778
vs. Medicare Baseline: 5.59x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Memorial Hospital of Carbon County is $1,993. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,778. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.59x the Medicare baseline. Located in 2221 West Elm Street, Rawlins, WY.

Cash / Self-Pay

$1,778

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,993

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: $1,778 (499%)

Insurance Median: $1,993 (559%)

Cash: $1,778 (499% of Medicare)

Ins. Median: $1,993 (559% 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 559% of the Medicare baseline (a markup of 459%). 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
Three_River_Providers_Network	$680 - $2,875	191%
Wise_Provider_Networks	$680 - $2,875	191%
Zelis	$680 - $2,875	191%
Corechoice	$816 - $3,450	229%
First_Choice_Health	$816 - $3,450	229%
Blue Cross Blue Shield	$834 - $3,526	234%
Cigna	$844 - $3,565	237%
UnitedHealthcare	$871 - $3,680	244%
Interwests_Ppo_Network	$880 - $3,718	247%
Multiplan	$880 - $3,718	247%
Medicare (plans)	$1,993	559%
Vaccn	$1,993	559%
Medicaid / KanCare	$3,833	1075%

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 $1,778.
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 Memorial Hospital of Carbon County 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.