CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Atrium Health Cleveland

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,402
Cash Discount Price: $2,659
vs. Medicare Baseline: 3.93x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Atrium Health Cleveland is $1,402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,659. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.93x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$2,659

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,402

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: $2,659 (746%)

Insurance Median: $1,402 (393%)

Cash: $2,659 (746% of Medicare)

Ins. Median: $1,402 (393% 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 393% of the Medicare baseline (a markup of 293%). 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
Trillium	$98 - $788	27%
Amerihealth Caritas	$99 - $750	28%
Carolina Complete Health	$99 - $765	28%
Healthy Blue	$99 - $765	28%
Partners	$99 - $745	28%
UnitedHealthcare	$99 - $2,840	28%
Vaya	$99 - $772	28%
Wellcare	$99 - $765	28%
Alliance	$100 - $890	28%
Cigna	$101 - $4,254	28%
Humana	$103 - $342	29%
Aetna	$105 - $4,095	29%
Blue Cross Blue Shield	$1,308 - $1,721	367%
Ambetter / Centene	$1,699 - $1,930	477%
Employers Health Network	$2,351	660%
Physician Reach Out	$2,659	746%
Medcost	$2,967 - $3,526	832%
Magellan	$3,191	895%
Gmmi	$3,457	970%
Quik Trip	$3,457	970%
Carolina Behavioral Health	$3,829 - $4,254	1074%
Healthgram	$4,254	1194%
Choicecare	$4,361	1224%
First Health	$4,520	1268%
Lifesynch Community Choice Care	$4,520	1268%
Private Health Care Systems	$4,786	1343%
Beechstreet	$4,893	1373%
Multiplan	$5,052	1417%

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 $2,659.
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 Atrium Health Cleveland 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.