CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,973
Cash Discount Price: $2,255
vs. Medicare Baseline: 5.54x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Novant Health Presbyterian Medical Center is $1,973. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,255. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.54x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$2,255

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,973

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: $2,255 (633%)

Insurance Median: $1,973 (554%)

Cash: $2,255 (633% of Medicare)

Ins. Median: $1,973 (554% 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 554% of the Medicare baseline (a markup of 454%). 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	$339 - $2,971	95%
Humana	$339 - $3,626	95%
Pace Of The Southern Piedmont	$339	95%
UnitedHealthcare	$339 - $2,941	95%
Aetna	$348 - $4,029	98%
Cigna	$349 - $2,594	98%
Liberty Health	$356	100%
Nc Department Of Public Safety	$678 - $877	190%
Carolina Complete	$694 - $877	195%
Amerihealth	$708 - $895	199%
Wellcare	$708 - $895	199%
Caresource North Carolina	$1,314 - $1,662	369%
Atlantic Corporation Dba Atlantic Packaging	$1,832 - $2,317	514%
Amps	$2,190 - $2,770	614%
Plotkin Health	$2,389 - $3,022	670%
Medcost	$2,827 - $3,777	793%
Primary Physician Care	$2,947 - $3,727	827%
Multiplan	$2,986 - $3,777	838%
Phcs	$2,986 - $3,777	838%
Employers Choice Network	$3,863 - $4,885	1084%
Three Rivers Provider Network	$3,863 - $4,885	1084%

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 $2,255.
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 Presbyterian 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.