CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: The McDowell Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,796
Cash Discount Price: $8,180
vs. Medicare Baseline: 10.65x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at The McDowell Hospital is $3,796. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,180. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.65x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$8,180

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,796

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: $8,180 (2295%)

Insurance Median: $3,796 (1065%)

Cash: $8,180 (2295% of Medicare)

Ins. Median: $3,796 (1065% 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 1065% of the Medicare baseline (a markup of 965%). 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	$1,090	306%
United	$1,106 - $4,205	310%
Wellcare	$1,122	315%
Amerihealth	$1,133	318%
Partners Health Management	$1,144	321%
Vaya Health	$1,144	321%
Apex Health	$1,636	459%
Cigna	$2,806 - $4,376	787%
Caresource	$3,599	1010%
Medcost	$4,007 - $6,953	1124%
Magellan	$4,908	1377%
Magellan Behavioral Health	$4,908	1377%
Aetna	$5,914	1659%
Multiplan	$6,544	1836%
Avalon Administrative Services	$6,953	1951%
Prime Health	$7,198 - $7,362	2019%

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 $8,180.
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 The McDowell Hospital 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.