MRI brain and brainstem without and with contrast dye

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

MRI Brain W+W/O Contrast Ltd

Payers reporting CPT 70553

72 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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1	UnitedHealthcare fee schedule · outpatient · +40 other terms	810	$665.58	$761.86	$1.00 – $10,495
2	Aetna fee schedule · outpatient · +40 other terms	645	$535.58	$1,131	$1.00 – $9,503
3	Blue Cross Blue Shield fee schedule · outpatient · +38 other terms	541	$876.70	$1,163	$1.00 – $19,906
4	Humana fee schedule · outpatient · +36 other terms	455	$410.14	$754.37	$1.10 – $10,161
5	Cigna fee schedule · outpatient · +36 other terms	378	$839.08	$1,159	$59.88 – $17,031
6	Molina fee schedule · outpatient · +35 other terms	265	$418.95	$467.12	$1.05 – $3,371
7	Anthem fee schedule · outpatient · +37 other terms	222	$825.39	$715.13	$8.29 – $10,686
8	WellCare fee schedule · outpatient · +28 other terms	198	$380.64	$415.31	$85.45 – $1,676
9	MultiPlan fee schedule · outpatient · +25 other terms	131	$4,367	$3,481	$139.10 – $10,768
10	Ambetter fee schedule · outpatient · +26 other terms	120	$553.80	$521.35	$60.00 – $3,743
11	Kaiser fee schedule · outpatient · +28 other terms	112	$712.42	$1,089	$107.00 – $9,714
12	Devoted facility · fee schedule · outpatient · +20 other terms	102	$349.93	$400.01	$301.79 – $4,896
13	Caresource fee schedule · outpatient · +24 other terms	90	$458.32	$598.79	$1.08 – $2,050
14	Aetna Better Health fee schedule · outpatient · +20 other terms	89	$359.42	$392.34	$178.22 – $1,295
15	Tricare facility · fee schedule · outpatient · +21 other terms	88	$350.46	$681.99	$48.95 – $6,396
16	Medica fee schedule · outpatient · +30 other terms	80	$729.77	$1,118	$87.16 – $5,866
17	Highmark facility · fee schedule · outpatient · +24 other terms	70	$594.79	$1,322	$81.59 – $8,060
18	Oscar facility · fee schedule · outpatient · +24 other terms	69	$509.98	$500.91	$326.10 – $982.70
19	First Health fee schedule · outpatient · +24 other terms	64	$1,494	$2,103	$128.40 – $9,422
20	Optum fee schedule · outpatient · +27 other terms	58	$328.78	$1,432	$114.99 – $9,724
21	Amerihealth Caritas facility · fee schedule · outpatient · +20 other terms	57	$406.80	$467.09	$269.00 – $1,270
22	Medicaid facility · fee schedule · outpatient · +21 other terms	57	$332.39	$386.26	$183.49 – $1,367
23	Medicare other · both · +23 other terms	53	$369.11	$501.02	$326.06 – $4,479
24	Cigna Healthspring fee schedule · outpatient · +11 other terms	42	$354.44	$386.73	$326.66 – $666.06
25	Clover facility · fee schedule · outpatient · +16 other terms	36	$367.43	$359.70	$303.69 – $420.58

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