CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Good Samaritan Hospital of Suffern

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,558
  • Cash Discount Price: $7,115
  • vs. Medicare Baseline: 9.98x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Good Samaritan Hospital of Suffern is $3,558. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,115. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.98x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.
Cash / Self-Pay
$7,115

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,558

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: $7,115 (1996%)
Insurance Median: $3,558 (998%)
Cash: $7,115 (1996% of Medicare)
Ins. Median: $3,558 (998% 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 998% of the Medicare baseline (a markup of 898%). 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
Mvp Gold (McR) $433 121%
Medicare (plans) $433 - $464 121%
Hamaspik (McR) $433 121%
Tricare $435 122%
Affinity By Molina McR $455 128%
Beacon Exchange $520 146%
Emblem $529 - $1,124 148%
Beacon Commercial $563 158%
Emblem Select Care (Exchange) $712 200%
Aetna $715 - $796 201%
Emblem Ghi/Hip PPO $838 235%
Cigna $860 241%
Geisinger Health Commercial/Exchange $1,430 401%
Mvp Exchange $1,645 462%
Mvp Hmo/Ppo $1,935 543%
Self-Pay - Cc 30% $2,134 599%
Self-Pay - Cc 50% $3,558 998%
Cdphp $3,558 998%
Blue Cross Blue Shield $3,704 - $22,869 1039%
Oxford Commercial $3,724 1045%
Self-Pay $4,098 1150%
Magnacare Standard $4,980 1397%
PHCS $5,336 1497%
Multiplan $5,336 1497%
Emblem Ghi/Hip Hmo/Epo/Pos $5,692 1597%
First Health $6,048 1697%
UnitedHealthcare $6,326 - $7,442 1775%
Oxford Exchange $6,326 1775%
Magnacare Preferred $6,404 1797%
Mvp $61,089 - $71,998 17139%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 Lafayette Avenue, Suffern, NY 10901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals