CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Novant Health Forsyth Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,430
Cash Discount Price: $1,321
vs. Medicare Baseline: 5.87x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Novant Health Forsyth Medical Center is $1,430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,321. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.87x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$1,321

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,430

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: $1,321 (542%)

Insurance Median: $1,430 (587%)

Cash: $1,321 (542% of Medicare)

Ins. Median: $1,430 (587% 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 587% of the Medicare baseline (a markup of 487%). 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	$231 - $1,737	95%
Humana	$231 - $1,970	95%
Pace Of The Southern Piedmont	$231	95%
UnitedHealthcare	$231 - $1,702	95%
Aetna	$237 - $2,023	97%
Cigna	$238 - $1,502	98%
Liberty Health	$243	100%
Carolina Complete	$386 - $470	158%
Nc Department Of Public Safety	$386 - $470	158%
Amerihealth	$394 - $479	162%
Wellcare	$394 - $479	162%
Caresource North Carolina	$832 - $1,012	341%
Atlantic Corporation Dba Atlantic Packaging	$1,175 - $1,429	482%
Plotkin Health	$1,248 - $1,517	512%
Amps	$1,352 - $1,644	555%
Medcost	$1,768 - $2,377	725%
Primary Physician Care	$1,830 - $2,226	751%
Beechstreet	$1,872 - $2,276	768%
Multiplan	$1,872 - $2,276	768%
Phcs	$1,872 - $2,276	768%
Employers Choice Network	$2,018 - $2,453	828%
Three Rivers Provider Network	$2,018 - $2,453	828%

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 $1,321.
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 Novant Health Forsyth Medical Center 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.