CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Blue Ridge Regional Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,321
  • Cash Discount Price: $8,180
  • vs. Medicare Baseline: 9.32x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Blue Ridge Regional Hospital is $3,321. 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 9.32x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$8,180

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,321

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: $3,321 (932%)
Cash: $8,180 (2295% of Medicare)
Ins. Median: $3,321 (932% 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 932% of the Medicare baseline (a markup of 832%). 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 $1,309 - $1,373 367%
United $1,393 - $3,869 391%
Wellcare $1,414 397%
Amerihealth $1,427 400%
Partners Health Management $1,441 404%
Vaya Health $1,441 404%
Aetna $1,636 - $5,914 459%
Apex Health $1,636 459%
Cigna $2,781 - $3,346 780%
Amerihealth Caritas $3,027 849%
Caresource $3,599 1010%
Medcost $3,812 - $4,235 1069%
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: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals