CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: North Carolina Baptist Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,588
  • Cash Discount Price: $2,336
  • vs. Medicare Baseline: 4.46x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at North Carolina Baptist Hospital is $1,588. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,336. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.46x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$2,336

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,588

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: $2,336 (655%)
Insurance Median: $1,588 (446%)
Cash: $2,336 (655% of Medicare)
Ins. Median: $1,588 (446% 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 446% of the Medicare baseline (a markup of 346%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $346 - $4,077 97%
Apex $346 97%
Blue Cross Blue Shield $346 - $2,121 97%
Cigna $346 - $2,878 97%
Devoted $346 97%
Healthteam $346 97%
UnitedHealthcare $346 - $1,781 97%
Wellcare $346 - $1,098 97%
Humana $349 - $2,624 98%
Medicare (plans) $349 98%
Liberty $398 112%
Medcost $900 - $3,190 253%
Amerihealth $1,027 - $1,293 288%
Carolina Complete $1,027 - $1,084 288%
Health Blue $1,027 - $1,084 288%
Partners $1,027 - $1,084 288%
Vaya $1,038 - $1,095 291%
Alliance $1,048 - $1,106 294%
Trillium $1,058 - $1,117 297%
Ambetter / Centene $1,227 - $1,295 344%
Oscar $1,364 - $1,727 383%
Directnet $2,687 - $2,835 754%
Cone Health $3,182 - $3,358 893%
Healthgram $3,182 - $3,358 893%
First Carolina Care $3,637 - $3,838 1020%
Private Healthcare Systems $3,728 - $3,934 1046%
Multiplan $4,091 - $4,317 1148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals