Heart MRI without 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 Cardiac W/O Contrast

Payers reporting CPT 75557

Payer pricing summary

Low

$187

Average

$908

Median

$768

High

$3.3k

Payer rate distribution

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Filter by billing class

#
1	Medicare other · both · +19 other terms	36	$243	$280	$195	69%	26–107	$221 – $1.6k
2	Anthem fee schedule · outpatient · +28 other terms	174	$705	$612	$670	109%	3–30	$6 – $6.5k
3	Cigna fee schedule · outpatient · +33 other terms	322	$576	$849	$861	102%	2–20	$61 – $9.7k
4	Tricare facility · fee schedule · outpatient · +19 other terms	47	$240	$265	$348	131%	2–20	$49 – $4.6k
5	Wellmark case rate · outpatient · +14 other terms	13	$230	$475	$509	107%	2–20	$227 – $2.2k
6	UnitedHealthcare fee schedule · outpatient · +37 other terms	677	$402	$471	$491	104%	1–10	$1 – $9.7k
7	Molina fee schedule · outpatient · +29 other terms	213	$292	$334	$363	109%	1–10	$1 – $8.0k
8	Aetna fee schedule · outpatient · +37 other terms	554	$379	$745	$796	107%	—	$1 – $10.0k
9	Blue Cross Blue Shield fee schedule · outpatient · +34 other terms	444	$502	$699	$907	130%	—	$1 – $20.1k
10	Humana fee schedule · outpatient · +31 other terms	370	$268	$567	$701	124%	—	$1 – $3.8k
11	WellCare fee schedule · outpatient · +23 other terms	156	$254	$272	$116	43%	—	$115 – $998
12	Kaiser fee schedule · outpatient · +26 other terms	101	$485	$753	$969	129%	—	$1 – $6.3k
13	Ambetter fee schedule · outpatient · +21 other terms	98	$401	$343	$152	44%	—	$148 – $778
14	MultiPlan fee schedule · outpatient · +21 other terms	83	$1.2k	$1.2k	$1.3k	107%	—	$143 – $6.7k
15	Devoted facility · fee schedule · outpatient · +17 other terms	80	$239	$260	$315	121%	—	$57 – $4.9k
16	Aetna Better Health fee schedule · outpatient · +19 other terms	74	$252	$259	$83	32%	—	$122 – $1.2k
17	Caresource fee schedule · outpatient · +19 other terms	70	$247	$371	$192	52%	—	$1 – $719
18	Oscar facility · fee schedule · outpatient · +21 other terms	60	$342	$357	$75	21%	—	$221 – $672
19	Highmark facility · fee schedule · outpatient · +21 other terms	59	$392	$459	$521	114%	—	$82 – $3.9k
20	First Health fee schedule · outpatient · +19 other terms	54	$468	$836	$1.5k	176%	—	$132 – $10.6k
21	Optum fee schedule · outpatient · +21 other terms	46	$252	$717	$766	107%	—	$118 – $3.0k
22	Amerihealth Caritas facility · fee schedule · outpatient · +15 other terms	43	$413	$417	$160	38%	—	$166 – $1.3k
23	Clover fee schedule · outpatient · +11 other terms	33	$264	$256	$18	7%	—	$215 – $288
24	Cigna Healthspring fee schedule · outpatient · +11 other terms	31	$245	$243	$4	2%	—	$233 – $254
25	Superior Healthplan facility · fee schedule · outpatient · +7 other terms	29	$243	$252	$39	16%	—	$233 – $473

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