CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Atrium Health Lincoln

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $921
Cash Discount Price: $1,765
vs. Medicare Baseline: 3.78x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Atrium Health Lincoln is $921. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,765. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.78x the Medicare baseline. Located in 433 McAlister Rd, Lincolnton, NC.

Cash / Self-Pay

$1,765

Average discount available for prompt cash payment at this facility.

Insurance Median

$921

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: $1,765 (724%)

Insurance Median: $921 (378%)

Cash: $1,765 (724% of Medicare)

Ins. Median: $921 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Trillium	$61 - $440	25%
Alliance	$62 - $448	25%
Amerihealth Caritas	$62 - $444	25%
Carolina Complete Health	$62 - $444	25%
Healthy Blue	$62 - $444	25%
Partners	$62 - $444	25%
UnitedHealthcare	$62 - $2,012	25%
Vaya	$62 - $444	25%
Wellcare	$62 - $444	25%
Cigna	$65 - $2,383	27%
Humana	$67 - $231	27%
Aetna	$68 - $3,001	28%
Orthocarolina	$82 - $283	34%
Blue Cross Blue Shield	$1,012 - $1,796	415%
Ambetter / Centene	$1,155 - $1,313	474%
Employers Health Network	$1,560	640%
Medcost	$1,663 - $2,309	682%
Physician Reach Out	$1,765	724%
Gmmi	$2,295	941%
Quik Trip	$2,295	941%
Choicecare	$2,895	1188%
First Health	$3,001	1231%
Beechstreet	$3,178	1304%
Private Health Care Systems	$3,178	1304%
Multiplan	$3,354	1376%

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 $1,765.
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 Atrium Health Lincoln 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.