CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Novant Health Ballantyne Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,483
Cash Discount Price: $1,586
vs. Medicare Baseline: 6.08x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Novant Health Ballantyne Medical Center is $1,483. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,586. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.08x the Medicare baseline. Located in 10905 Providence Road W, Charlotte, NC.

Cash / Self-Pay

$1,586

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,483

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: $1,586 (651%)

Insurance Median: $1,483 (608%)

Cash: $1,586 (651% of Medicare)

Ins. Median: $1,483 (608% 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 608% of the Medicare baseline (a markup of 508%). 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	$232 - $1,913	95%
Humana	$232 - $2,335	95%
Pace Of The Southern Piedmont	$232	95%
UnitedHealthcare	$232 - $1,894	95%
Aetna	$238 - $2,594	98%
Cigna	$239 - $1,670	98%
Liberty Health	$243	100%
Nc Department Of Public Safety	$464 - $661	190%
Carolina Complete	$632 - $661	259%
Amerihealth	$645 - $675	265%
Wellcare	$645 - $675	265%
Caresource North Carolina	$1,023 - $1,070	420%
Atlantic Corporation Dba Atlantic Packaging	$1,426 - $1,492	585%
Amps	$1,704 - $1,784	699%
Plotkin Health	$1,859 - $1,946	763%
Medcost	$2,200 - $2,432	902%
Primary Physician Care	$2,293 - $2,400	941%
Multiplan	$2,324 - $2,432	953%
Phcs	$2,324 - $2,432	953%
Employers Choice Network	$3,006 - $3,146	1233%
Three Rivers Provider Network	$3,006 - $3,146	1233%

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 $1,586.
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 Novant Health Ballantyne 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.