CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,354
  • Cash Discount Price: $8,180
  • vs. Medicare Baseline: 9.41x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Transylvania Regional Hospital, Inc is $3,354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,180. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.41x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
$8,180

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,354

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: $8,180 (2295%)
Insurance Median: $3,354 (941%)
Cash: $8,180 (2295% of Medicare)
Ins. Median: $3,354 (941% 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 941% of the Medicare baseline (a markup of 841%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $1,545 - $1,636 433%
United $1,568 - $3,681 440%
Wellcare $1,592 447%
Amerihealth $1,607 451%
Partners Health Management $1,622 455%
Vaya Health $1,622 455%
Apex Health $1,636 459%
Aetna $2,127 - $5,914 597%
Cigna $2,994 - $4,164 840%
Amerihealth Caritas $3,354 941%
Caresource $3,599 1010%
Medcost $4,578 - $6,953 1284%
Magellan $4,908 1377%
Magellan Behavioral Health $4,908 1377%
Multiplan $6,544 1836%
Avalon Administrative Services $6,953 1951%
Prime Health $7,198 - $7,362 2019%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals