CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Carolina East Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,742
Cash Discount Price: $2,258
vs. Medicare Baseline: 11.25x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Carolina East Medical Center is $2,742. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,258. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.25x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$2,258

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,742

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: $2,258 (926%)

Insurance Median: $2,742 (1125%)

Cash: $2,258 (926% of Medicare)

Ins. Median: $2,742 (1125% 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 1125% of the Medicare baseline (a markup of 1025%). 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
Humana	$228	94%
Inclusive Health (Nchirp)-All Plans	$228	94%
Pamlico Co Jail-All Plans	$1,001	411%
Craven Co. Jail Systems - All Plans	$1,268	520%
Medcost Ppo Ultra (Employees)	$2,355	966%
Medcost Ppo Employees And Retirees	$2,471	1014%
Blue Cross Blue Shield	$2,582	1059%
UnitedHealthcare	$2,676	1098%
Medcost Ppo City Employees	$2,742	1125%
Medcost Ppo County Employee	$2,851	1170%
Benefit Mgmt, Svcs-All Plans	$3,199	1312%
Medcost Benefit Svc-All Other Plans	$3,327	1365%
Aetna	$3,335	1368%
Acs Consult Svc Inc-All Plans	$3,400	1395%
Medcost Ppo Standard	$3,400	1395%
Cigna	$3,425	1405%
Tricare	$3,764	1544%

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 $2,258.
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 Carolina East Medical Center 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.