CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Norton-King's Daughters' Health

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,170
Cash Discount Price: $502
vs. Medicare Baseline: 4.80x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Norton-King's Daughters' Health is $1,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.80x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$502

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,170

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: $502 (206%)

Insurance Median: $1,170 (480%)

Cash: $502 (206% of Medicare)

Ins. Median: $1,170 (480% 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 480% of the Medicare baseline (a markup of 380%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$64 - $1,256	26%
Blue Cross Blue Shield	$117 - $1,159	48%
Humana	$117 - $253	48%
Managed Health Services Of Kentucky	$117	48%
Passport By Molina	$117	48%
Managed Health Services Of Indiana	$119	49%
UnitedHealthcare	$119 - $1,793	49%
Managed Health Services	$261 - $392	107%
Caresource Of Kentucky	$355	146%
Caresource Of Indiana	$380	156%
Custom Design Benefits	$506 - $1,142	208%
Cigna	$1,941	796%
Encore	$1,941	796%
Quality Care Partners	$2,033	834%
Bluegrass	$2,056	843%
First Health	$2,056	843%
Healthlink	$2,056	843%
Vha/Tristate	$2,056	843%
Multiplan/Phcs	$2,101	862%
Indiana Health Network	$2,170	890%
Siho	$2,170	890%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $502.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Norton-King's Daughters' Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.