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Signature Cross-Insurance Cost Matrix • CPT 70551

Brain MRI Without Contrast: Cost Across Insurances

Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.

View 14-Hospital Facility Price TableAdd your insurance card to see YOUR priceMedical Necessity & Prior Auth Checklist
1. Published Prices(Cash & Medicare)2. Plan-Adjusted(Payer MRF Rate)3. Verified Price(Real-Time 270/271 Check)

Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.

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Tier 1: General Published Rates Across 9 InsurancesEvery cell labeled with official Source + Date • “Not published” shown honestly where proprietary

Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.

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Parkinson's Service / Medication
Self-Pay / Cash Price
Hospital MRF / Retail Cash
Medicare Rate
2026 CMS / NADAC / Part D
Anthem Blue Cross
MRF Negotiated / Formulary
Blue Shield of CA
MRF Negotiated / Formulary
UnitedHealthcare
MRF Negotiated / Formulary
Aetna
MRF Negotiated / Formulary
Cigna
MRF Negotiated / Formulary
Kaiser Permanente
MRF Negotiated / Formulary
Medi-Cal (CA Medicaid)
CA DHCS / Medi-Cal Rx
Pathway ServiceCPT 70551
Brain MRI Without Contrast
14-Hospital Breakdown →
$1,719–$5,481

Self-pay discounted cash / negotiated spread ($135–$8,227 overall across 14 Bay Area hospitals)

Source: 14 Bay Area Hospital MRFs (45 CFR § 180.50)
Date: Oct 2026
$339.26

CMS 2026 allowed rate (~$67.85 Part B 20% coinsurance; $0 with Medigap Plan G)

Source: CMS CY 2026 Hospital Outpatient Prospective Payment System (OPPS APC 5523) & Medicare Physician Fee Schedule (Noridian JE Bay Area Locality)
Date: CY 2026 (Jan 2026)
$278–$5,724

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Cross (Anthem Medicare Managed Care Plan) ($504); UCSF Medical Center (SF): Blue Cross (Anthem Medi-Cal Managed Care Plan) ($492))

Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Date: 2026-10-01
$167–$8,227

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($436); UCSF Medical Center (SF): Blue Shield (Covered California Other Commercial Plan) ($3,939))

Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Date: 2026-10-01
$354–$5,363

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($419); UCSF Medical Center (SF): Unitedhealthcare (Apple Other Commercial Plan) ($3,264))

Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Date: 2026-10-01
$349–$4,971

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Aetna (All Commercial Plans) ($3,951); Stanford Hospital (Palo Alto): Aetna (All Commercial Plans) ($4,971))

Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Date: 2026-10-01
$2,522–$7,447

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Cigna (All Commercial Plans) ($4,180); Stanford Hospital (Palo Alto): Cigna (Hmo/Pos) ($4,439))

Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Date: 2026-10-01
$349–$4,770

Negotiated across 2 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Kaiser Permanente (All Commercial Plans) ($4,770); Washington Hospital (Fremont): KAISER MEDI-CAL ($439))

Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50)
Date: 2026-10-01
$0 patient copay

Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$271)

Source: CA DHCS 2026 Medi-Cal Rates & Cost-Sharing Rules
Date: Oct 2026
Audit-Grade Cell Verification (9/9 Insurance Columns Sourced)

Every Insurance Cell for Brain MRI Without Contrast — With Source & Date Citations

Tier 1 Cash Baseline Published Rate

Self-Pay / Discounted Cash Price

$1,719–$5,481

Self-pay discounted cash / negotiated spread ($135–$8,227 overall across 14 Bay Area hospitals)

Official Source: 14 Bay Area Hospital MRFs (45 CFR § 180.50)
Effective / Verified Date: Oct 2026
Federal Benchmark Published Rate

Original Medicare (CMS 2026 / NADAC / Part D)

$339.26

CMS 2026 allowed rate (~$67.85 Part B 20% coinsurance; $0 with Medigap Plan G)

Official Source: CMS CY 2026 Hospital Outpatient Prospective Payment System (OPPS APC 5523) & Medicare Physician Fee Schedule (Noridian JE Bay Area Locality)
Effective / Verified Date: CY 2026 (Jan 2026)
Commercial & MA MRF Published Rate

Anthem Blue Cross (California)

$278–$5,724

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Cross (Anthem Medicare Managed Care Plan) ($504); UCSF Medical Center (SF): Blue Cross (Anthem Medi-Cal Managed Care Plan) ($492))

Official Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Effective / Verified Date: 2026-10-01
Commercial & MA MRF Published Rate

Blue Shield of California

$167–$8,227

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Blue Shield (Medicare Managed Care Plan) ($436); UCSF Medical Center (SF): Blue Shield (Covered California Other Commercial Plan) ($3,939))

Official Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Effective / Verified Date: 2026-10-01
Commercial & MA MRF Published Rate

UnitedHealthcare (UHC)

$354–$5,363

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Unitedhealthcare (Medicare Managed Care Plan) ($419); UCSF Medical Center (SF): Unitedhealthcare (Apple Other Commercial Plan) ($3,264))

Official Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Effective / Verified Date: 2026-10-01
Commercial & MA MRF Published Rate

Aetna

$349–$4,971

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Aetna (All Commercial Plans) ($3,951); Stanford Hospital (Palo Alto): Aetna (All Commercial Plans) ($4,971))

Official Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Effective / Verified Date: 2026-10-01
Commercial MRF Published Rate

Cigna

$2,522–$7,447

Negotiated across 14 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Cigna (All Commercial Plans) ($4,180); Stanford Hospital (Palo Alto): Cigna (Hmo/Pos) ($4,439))

Official Source: Bay Area Hospital MRFs (14/14 facilities, 45 CFR § 180.50)
Effective / Verified Date: 2026-10-01
Integrated HMO / MRF Published Rate

Kaiser Permanente (Northern CA)

$349–$4,770

Negotiated across 2 Bay Area hospital MRFs (e.g., UCSF Medical Center (SF): Kaiser Permanente (All Commercial Plans) ($4,770); Washington Hospital (Fremont): KAISER MEDI-CAL ($439))

Official Source: Bay Area Hospital MRFs (2/14 facilities, 45 CFR § 180.50)
Effective / Verified Date: 2026-10-01
$0 Safety-Net Published Rate

Medi-Cal (California Medicaid / Medi-Cal Rx)

$0 patient copay

Medi-Cal Fee-For-Service / Managed Care ($0 beneficiary cost-sharing; provider benchmark ~$271)

Official Source: CA DHCS 2026 Medi-Cal Rates & Cost-Sharing Rules
Effective / Verified Date: Oct 2026
14 Bay Area Hospital MRF Facility Breakdown

Hospital-by-Hospital Published Rates for Brain MRI Without Contrast

Open Full Interactive Procedure Page
Bay Area HospitalSelf-Pay Cash Price2026 Medicare RateNegotiated Payer Min–MaxAudited Payer Families
UCSF Medical Center (SF)
San Francisco • UCSF Health
$1,719$339$135–$8,227Medicare Advantage, Aetna, Medi-Cal / County Managed Care, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Kaiser Permanente, UnitedHealthcare
Stanford Hospital (Palo Alto)
Palo Alto • Stanford Medicine
$4,698$339$351–$7,447Medicare Advantage, Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Medi-Cal / County Managed Care, Health Net, UnitedHealthcare
Stanford Tri-Valley (Pleasanton)
Pleasanton • Stanford Medicine
$2,769$339$300–$4,131Blue Shield of California, Aetna, Medi-Cal / County Managed Care, Anthem Blue Cross, Cigna, Health Net, UnitedHealthcare
El Camino Health (Mountain View)
Mountain View • El Camino Health
$2,608$339$164–$7,355Aetna, Medicare Advantage, Anthem Blue Cross, Medi-Cal / County Managed Care, Blue Shield of California, Cigna, Health Net, UnitedHealthcare
Washington Hospital (Fremont)
Fremont • Washington Township Health Care District
$2,741$339$339–$4,006Medi-Cal / County Managed Care, Medicare Advantage, Anthem Blue Cross, Blue Shield of California, Canopy Health, Health Net, Kaiser Permanente, UnitedHealthcare, Aetna, Cigna
CPMC Van Ness (San Francisco)
San Francisco • Sutter Health
$5,481$339$2,235–$3,788Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, UnitedHealthcare
Alta Bates Medical Center (Berkeley)
Berkeley • Sutter Health
$5,481$339$339–$3,788Aetna, Cigna, Anthem Blue Cross, Health Net, UnitedHealthcare, Blue Shield of California, Medicare Advantage
Summit Medical Center (Oakland)
Oakland • Sutter Health
$5,481$339$339–$3,788Cigna, UnitedHealthcare, Anthem Blue Cross, Aetna, Health Net, Blue Shield of California, Medicare Advantage
Eden Medical Center (Castro Valley)
Castro Valley • Sutter Health
$5,481$339$339–$3,788Aetna, Anthem Blue Cross, UnitedHealthcare, Blue Shield of California, Cigna, Health Net, Medicare Advantage
Mills-Peninsula (Burlingame)
Burlingame • Sutter Health
$5,481$339$346–$3,788UnitedHealthcare, Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Medicare Advantage
Sutter Delta (Antioch)
Antioch • Sutter Health
$5,481$339$337–$3,788Aetna, Blue Shield of California, Anthem Blue Cross, Cigna, Health Net, UnitedHealthcare, Medicare Advantage
Novato Community Hospital (Marin)
Novato • Sutter Health
$5,481$339$2,235–$3,788Blue Shield of California, Anthem Blue Cross, UnitedHealthcare, Cigna, Aetna, Health Net
Sutter Santa Rosa Regional
Santa Rosa • Sutter Health
$5,481$339$328–$3,788Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, UnitedHealthcare, Medicare Advantage
Sutter Solano (Vallejo)
Vallejo • Sutter Health
$5,481$339$2,093–$3,788UnitedHealthcare, Health Net, Aetna, Blue Shield of California, Cigna, Anthem Blue Cross