CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,308
  • Cash Discount Price: $2,315
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Nemours Children's Hospital, Delaware is $1,308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,315. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.37x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$2,315

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,308

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: $2,315 (950%)
Insurance Median: $1,308 (537%)
Cash: $2,315 (950% of Medicare)
Ins. Median: $1,308 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Us Family Health Plan $78 32%
Tricare $253 104%
Celtic Transplant $338 - $2,315 139%
Keystone First Hlth Plan $462 - $1,024 190%
Amerihealth Caritas Delaware $709 - $1,320 291%
Blue Cross Blue Shield $717 - $2,044 294%
Celtic Transplant For De First Health $810 332%
Delaware First Health $833 342%
UnitedHealthcare $850 - $1,445 349%
Wellpoint Maryland $857 352%
Kidz Partners $876 359%
Health Partners $898 368%
Upmc $917 376%
Fidelis $926 380%
Aetna $982 - $1,343 403%
Priority Partners John Hopkins $1,136 466%
Six Degrees Health Transplant $1,158 475%
Cigna $1,273 - $1,458 522%
Great West-One Health Plan $1,273 - $1,458 522%
Ambetter / Centene $1,320 541%
Geisinger Health Plan $1,389 570%
Integra Administrative Group $1,389 570%
National Transplant Network (Ntn) $1,505 617%
Six Degrees Health $1,505 617%
Star Healthcare Network $1,505 617%
Life Trac Solid Organ And Bmt Transplant $1,620 665%
First Health Network $2,199 902%
Insurance Administrators Of America $2,199 902%
Interlink Transplant Network $2,199 902%
Multiplan $2,199 902%
Preferred Healthcare $2,199 902%
Private Healthcare Systems $2,199 902%
Three Rivers Provider Network $2,199 902%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens