CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Wilkes Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,454
Cash Discount Price: $2,404
vs. Medicare Baseline: 6.88x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Wilkes Regional Medical Center is $2,454. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,404. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.88x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.

Cash / Self-Pay

$2,404

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,454

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: $2,404 (674%)

Insurance Median: $2,454 (688%)

Cash: $2,404 (674% of Medicare)

Ins. Median: $2,454 (688% 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 688% of the Medicare baseline (a markup of 588%). 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
Healthteam	$351	98%
Amerihealth	$900 - $2,793	253%
Carolina Complete	$900	253%
Healthblue	$900	253%
Partners	$900	253%
UnitedHealthcare	$909 - $2,567	255%
Vaya	$909	255%
Wellcare	$909	255%
Alliance	$917	257%
Trillium	$926	260%
Medcost	$1,385 - $3,433	389%
Blue Cross Blue Shield	$1,669 - $2,806	468%
Aetna	$1,827 - $3,303	513%
Ambetter / Centene	$2,034 - $2,928	571%
Cigna	$2,519 - $2,606	707%
Oscar	$2,644 - $3,125	742%
Directnet	$2,842	797%
Private Healthcare Systems	$4,327	1214%
Multiplan	$4,423	1241%

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 $2,404.
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 Wilkes Regional 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.