CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Northside Hospital Duluth

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,581
  • Cash Discount Price: $5,735
  • vs. Medicare Baseline: 4.44x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Northside Hospital Duluth is $1,581. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,735. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.44x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$5,735

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,581

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $5,735 (1609%)
Insurance Median: $1,581 (444%)
Cash: $5,735 (1609% of Medicare)
Ins. Median: $1,581 (444% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 444% of the Medicare baseline (a markup of 344%). 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
Champus Va $209 59%
Blue Cross Blue Shield $344 - $5,330 97%
Clear Springs Eon Health $344 97%
Medicare (plans) $344 - $413 97%
UnitedHealthcare $344 - $2,367 97%
Va Ccn $344 97%
Aetna $348 - $2,300 98%
Humana $348 - $358 98%
Bccp $350 98%
Cbww $350 98%
Coventry $351 - $5,200 98%
Tricare $354 99%
Caresource $355 - $2,845 100%
Kaiser $355 - $1,961 100%
Wellcare $355 100%
Clover Health $361 101%
Pruitt Health Premier $362 102%
One Call Diagnostics $499 140%
Us Dept Of Labor Wc $518 145%
Mti $519 146%
Homelink $551 155%
Streamline Imaging $565 159%
Fairly Group $600 168%
Health One Alliance_Ppo $700 196%
Genex/Priority Care Solutions $748 210%
Spreemo $748 210%
Med Care Solutions $750 210%
Medlien Healthcare Services $775 217%
Authentic 4D $842 236%
Corvel Workers Comp $889 249%
Employers Choice Network $889 249%
Fieldale Farms Wc $936 263%
Georgia Workers Compensation $936 263%
Direct Pay Provider Network Llc $945 265%
Ambetter / Centene $966 - $1,640 271%
Amerigroup $966 - $1,373 271%
Institutional Gwinnett County Govt $966 - $1,373 271%
Medicaid / KanCare $966 - $1,579 271%
Cigna $1,161 - $1,581 326%
Oscar $1,171 329%
Truths Community $1,199 336%
Good Samaritan Radiology $1,528 429%
Northside Health Network $1,982 556%
Georgia Reproductive Specialists $3,059 858%
Quick Trip $4,206 1180%
Novanet_Ppo $5,353 1502%
Phcs $5,735 1609%
Beech Steet $6,500 1824%
Multiplan $6,500 1824%
Multiplan Workers Comp $6,500 1824%
Careiq $7,647 2145%
Dekalb_Department Of Health $7,647 2145%
Fifa $7,647 2145%
Institutional Marietta Surgery Center $7,647 2145%
Institutional Veterans Evaluation Services $7,647 2145%
Johnson Ferry Imaging $7,647 2145%
Marietta Dermatology Clinical Research Inc $7,647 2145%
Rabun County Boc $7,647 2145%
West Paces Imaging Agreement $7,647 2145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals