CMS Price Transparency Data

MRI, brain (no contrast)

Facility: St Anthony Community Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $2,171
  • Cash Discount Price: $4,342
  • vs. Medicare Baseline: 8.91x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at St Anthony Community Hospital is $2,171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,342. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.91x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$4,342

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,171

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $4,342 (1781%)
Insurance Median: $2,171 (891%)
Cash: $4,342 (1781% of Medicare)
Ins. Median: $2,171 (891% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 891% of the Medicare baseline (a markup of 791%). 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
Medicare (plans) $296 - $317 121%
Hamaspik (McR) $296 121%
Mvp Gold (McR) $296 121%
Tricare $298 - $6,112 122%
Affinity By Molina McR $311 128%
Emblem $316 - $602 130%
Emblem Select Care (Exchange) $368 151%
Aetna $397 - $441 163%
Emblem Ghi/Hip PPO $432 177%
Cigna $517 212%
Mvp Exchange $546 - $1,645 224%
Geisinger Health Commercial/Exchange $978 401%
Mvp Hmo/Ppo $1,062 - $1,935 436%
Self-Pay - Cc 30% $1,303 535%
Self-Pay - Cc 50% $2,171 891%
Cdphp $2,171 891%
Blue Cross Blue Shield $2,381 - $14,703 977%
Self-Pay $2,635 1081%
Multiplan $3,256 1336%
PHCS $3,256 1336%
Emblem Ghi/Hip Hmo/Epo/Pos $3,474 1425%
First Health $3,691 1514%
Oxford Commercial $3,724 1528%
Magnacare Preferred $3,908 1603%
UnitedHealthcare $6,326 - $7,442 2595%
Oxford Exchange $6,326 2595%
Mvp $41,347 - $48,731 16961%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals