CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Carolina East Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,844
Cash Discount Price: $3,166
vs. Medicare Baseline: 10.78x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Carolina East Medical Center is $3,844. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,166. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.78x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$3,166

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,844

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: $3,166 (888%)

Insurance Median: $3,844 (1078%)

Cash: $3,166 (888% of Medicare)

Ins. Median: $3,844 (1078% 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 1078% of the Medicare baseline (a markup of 978%). 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	$333	93%
Inclusive Health (Nchirp)-All Plans	$333	93%
Pamlico Co Jail-All Plans	$1,404	394%
Craven Co. Jail Systems - All Plans	$1,778	499%
Medcost Ppo Ultra (Employees)	$3,301	926%
Medcost Ppo Employees And Retirees	$3,465	972%
Blue Cross Blue Shield	$3,619	1015%
UnitedHealthcare	$3,752	1053%
Medcost Ppo City Employees	$3,844	1078%
Medcost Ppo County Employee	$3,997	1121%
Benefit Mgmt, Svcs-All Plans	$4,485	1258%
Medcost Benefit Svc-All Other Plans	$4,664	1309%
Aetna	$4,675	1312%
Acs Consult Svc Inc-All Plans	$4,766	1337%
Medcost Ppo Standard	$4,766	1337%
Cigna	$4,802	1347%
Tricare	$5,277	1481%

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 $3,166.
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 Carolina East 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.