CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Major Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,767
Cash Discount Price: $842
vs. Medicare Baseline: 7.25x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Major Hospital is $1,767. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $842. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.25x the Medicare baseline. Located in 2451 Intelliplex Dr, Shelbyville, IN.

Cash / Self-Pay

$842

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,767

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: $842 (345%)

Insurance Median: $1,767 (725%)

Cash: $842 (345% of Medicare)

Ins. Median: $1,767 (725% 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 725% of the Medicare baseline (a markup of 625%). 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
Blue Cross Blue Shield	$119 - $1,336	49%
Caresource Mrktplce -All Plans	$480	197%
Ambetter / Centene	$505	207%
Sho Direct-All Plans	$1,496	614%
UnitedHealthcare	$1,719 - $1,767	705%
Phcs - All Plans	$2,063	846%
Aetna	$2,281	936%
Siho-All Plans	$2,362	969%
Humana	$2,448	1004%
First Health - All Plans	$2,552	1047%
Cigna	$2,688	1103%

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 $842.
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 Major Hospital 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.