CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Novant Health Forsyth Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,102
Cash Discount Price: $2,074
vs. Medicare Baseline: 5.90x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Novant Health Forsyth Medical Center is $2,102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,074. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.90x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$2,074

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,102

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: $2,074 (582%)

Insurance Median: $2,102 (590%)

Cash: $2,074 (582% of Medicare)

Ins. Median: $2,102 (590% 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 590% of the Medicare baseline (a markup of 490%). 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	$338 - $2,699	95%
Humana	$338 - $3,060	95%
Pace Of The Southern Piedmont	$338	95%
UnitedHealthcare	$338 - $2,644	95%
Aetna	$347 - $3,142	97%
Cigna	$349 - $2,333	98%
Liberty Health	$355	100%
Carolina Complete	$628 - $729	176%
Nc Department Of Public Safety	$628 - $729	176%
Amerihealth	$640 - $744	180%
Wellcare	$640 - $744	180%
Caresource North Carolina	$1,352 - $1,571	379%
Atlantic Corporation Dba Atlantic Packaging	$1,910 - $2,219	536%
Plotkin Health	$2,029 - $2,357	569%
Amps	$2,198 - $2,553	617%
Medcost	$2,874 - $3,692	806%
Primary Physician Care	$2,975 - $3,457	835%
Beechstreet	$3,043 - $3,535	854%
Multiplan	$3,043 - $3,535	854%
Phcs	$3,043 - $3,535	854%
Employers Choice Network	$3,280 - $3,810	920%
Three Rivers Provider Network	$3,280 - $3,810	920%

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 $2,074.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

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 70553.
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.