CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Pender Memorial Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,002
Cash Discount Price: $1,373
vs. Medicare Baseline: 4.11x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Pender Memorial Hospital is $1,002. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,373. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.11x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$1,373

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,002

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: $1,373 (563%)

Insurance Median: $1,002 (411%)

Cash: $1,373 (563% of Medicare)

Ins. Median: $1,002 (411% 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 411% of the Medicare baseline (a markup of 311%). 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	$435 - $1,316	178%
Humana	$651 - $3,067	267%
Pace Of The Southern Piedmont	$685 - $963	281%
New Hanover Health	$699 - $982	287%
Aetna	$703 - $3,031	288%
Cigna	$706 - $1,573	290%
Carolina Complete	$713 - $1,002	292%
Nc Department Of Public Safety	$713 - $1,926	292%
Amerihealth	$727 - $1,022	298%
Wellcare	$727 - $1,022	298%
Ambetter / Centene	$959 - $1,348	393%
Liberty Health	$973 - $1,368	399%
Caresource North Carolina	$1,015 - $1,426	416%
Plotkin Health	$1,523 - $2,140	625%
UnitedHealthcare	$1,853 - $2,603	760%
Medcost	$1,911 - $2,992	784%
Employers Choice Network	$2,462 - $3,459	1010%
Three Rivers Provider Network	$2,462 - $3,459	1010%

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 $1,373.
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 Pender Memorial Hospital 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.