CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Duke University Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $740
Cash Discount Price: $876
vs. Medicare Baseline: 3.04x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Duke University Hospital is $740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $876. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.04x the Medicare baseline. Located in 2301 Erwin Rd, Durham, NC.

Cash / Self-Pay

$876

Average discount available for prompt cash payment at this facility.

Insurance Median

$740

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: $876 (359%)

Insurance Median: $740 (304%)

Cash: $876 (359% of Medicare)

Ins. Median: $740 (304% 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 304% of the Medicare baseline (a markup of 204%). 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	$225 - $1,814	92%
Blue Cross Blue Shield	$233 - $3,245	96%
UnitedHealthcare	$233 - $2,536	96%
Troy Health	$235	96%
Voans	$235	96%
Humana	$236 - $2,758	97%
Cigna	$240 - $3,245	98%
Liberty	$240	98%
Alliance Health	$734 - $831	301%
Amerihealth	$734 - $831	301%
Carolina Complete Health	$734 - $831	301%
Trillium	$734 - $831	301%
Partners	$815	334%
Medcost	$1,382	567%
Sentara	$2,022	829%

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 $876.
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 Duke University 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.