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Prices only. No diagnosis or treatment advice. Confirm your price in writing before service.

Outpatient prices - Medicare anchors - Facility-type explained

The same scan can cost more at a hospital. See the anchor before you book.

MyCarePrice shows the verified Medicare rate for common outpatient procedures and explains why the setting changes the bill. We publish prices only. We do not diagnose, recommend treatment, or tell you whether you should get a test.

How to use this site: Find your procedure, note the CPT code and the Medicare anchor, then ask the facility for the cash price for that exact code in that exact setting. Confirm the all-in price in writing before service.

  • CMS CY2025 sources named
  • Verified 2026-10-04
  • No invented self-pay ranges
  • Prices only - no medical advice

Price Anchor Explorer

Pick a procedure and a facility type. You will see the verified Medicare anchor and what changes with the setting. No invented self-pay numbers.

Imaging, lab, and procedure departments located in or owned by a hospital, including off-campus hospital departments

MRI Without Contrast

CPT 70551

Magnetic resonance imaging, brain (including brain stem); without contrast material

Physician Fee Schedule anchor

$193.67

Global (professional + technical)

Professional (26)
$68.81
Technical (TC)
$124.86

CMS Physician Fee Schedule CY2025 via WPS GHA, Michigan Locality 01 - CY2025. Verified 2026-10-04.

Hospital outpatient (OPPS) anchor

$540.27

APC 8007 - MRI and MRA without Contrast Composite (facility portion only)

Composite APC paid to the hospital facility when multiple imaging services on the same claim meet composite rules; single-service imaging APCs 5521 to 5524 also apply depending on the claim. Professional fee is billed separately.

CMS OPPS CY2025 Final Rule CMS-1809-FC - CY2025. Verified 2026-10-04.

What this means for Hospital outpatient

In a hospital outpatient department Medicare pays two parts: the OPPS facility payment (when an APC applies) and the PFS professional fee. That two-part structure is why the same CPT code usually costs more at a hospital than at an imaging center or office that bills a single global amount. Your cash quote should list facility and professional portions separately. Confirm the all-in price in writing before service.

Facility lever: Ask whether the MRI will be performed in a hospital outpatient department or a freestanding imaging center, and get the cash price for each setting in writing. The scan and report are the same CPT code in both places.

This explorer shows Medicare anchors only. Medicare payment is not your self-pay price. Self-pay cash prices are set by each facility and are not published on this page unless verified from a public source under Procedure Price Method v1.0. Always confirm your price in writing before service, including whether professional, facility, anesthesia, and pathology are included.

10 launch procedures

All procedures

Each page gives the CPT code, what the price includes and excludes, why prices vary, and the facility-type lever. Where a Medicare anchor was verified from a named CMS source, it is shown. Self-pay ranges are not invented.

Imaging CPT 70551

MRI Without Contrast

Magnetic resonance imaging, brain (including brain stem); without contrast material

Medicare PFS global anchor $193.67

Imaging CPT 70553

MRI With Contrast

Magnetic resonance imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences

Medicare PFS global anchor $314.74

Imaging CPT 74177

CT Abdomen and Pelvis

Computed tomography, abdomen and pelvis; with contrast material(s)

Medicare PFS global anchor $296.94

Imaging CPT 70450

CT Head

Computed tomography, head or brain; without contrast material

Medicare PFS global anchor $105.31

Imaging CPT 76700

Ultrasound Abdomen

Ultrasound, abdominal, real time with image documentation; complete

Medicare PFS global anchor $112.22

Imaging CPT 77067

Screening Mammogram

Screening mammography, bilateral (2-view study of each breast), including computer-aided detection when performed

Medicare PFS global anchor $124.39

Endoscopy CPT 45378

Colonoscopy

Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

Medicare PFS nonfacility $335.06

Endoscopy CPT 43235

Upper Endoscopy (EGD)

Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

Medicare PFS nonfacility $279.91

Imaging CPT 71046

X-Ray Chest

Radiologic examination, chest; 2 views

Medicare PFS global anchor $32.81

Imaging CPT 93306

Echocardiogram

Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography and with color flow Doppler echocardiography

Medicare PFS global anchor $187.76

Why the facility matters more than the machine

Medicare pays imaging and endoscopy under two different logics. A hospital outpatient department bills a facility payment under OPPS plus a professional fee. An imaging center or office usually bills one global amount under the Physician Fee Schedule. Same CPT code, different payment system.

Start with How Prices Work, then compare settings on the facility-type pages.

Sources and verification

  • Medicare (CMS) rates are shown as a separate anchor, never blended into a self-pay range. Physician Fee Schedule anchors are CY2025, Michigan Locality 01, verified 2026-10-04. Your locality amount will differ.
  • A self-pay range appears only where it can be verified from a public source. At launch, most pages ship the Medicare anchor plus facility-type education and state that self-pay ranges are not published yet.
  • Hospital machine-readable file list prices are not presented as what patients pay. See Methodology - Procedure Price Method v1.0 for limits.
  • Every price page repeats the same rule: confirm your price in writing before service.