CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Wentworth-Douglass Hospital

Billing Code: 70553 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$578

about 1.6× the $356 Medicare rate · typically $373–$1,385

modeled estimate · not a bill or quote

What this hospital charges insurers

$384

Below the fair price — a good deal

about $194 under the fair price · 1.1× Medicare

Medicare pays $356 Fair price $578 This hospital $384 Cash price $4,727 Hospital's list price $7,879

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

One of the lower prices — 6 of 8 other NH hospitals charge more for the same procedure.

Cheapest $216 Priciest $1,340

Black dot = this hospital, among the 9 NH hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, brain (with and without contrast) is about $578 (about 1.6× the $356 Medicare rate). Wentworth-Douglass Hospital charges insurers about $384, or about $4,727 in cash — below the fair price — a good deal. Located in Dover, NH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$373 - $6,098	105%
Blue Cross Blue Shieldmajor	$366 - $2,385	103%
Cignamajor	$4,483	1258%
Humanamajor	$384	108%
WellSense	$373 - $916	105%
+ 3 smaller / regional plans	$373 - $4,956

Government programs also on file: Medicare, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,727), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 70553.

Insurance Before you use insurance

Call your insurance company to confirm Wentworth-Douglass Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 70553.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Wentworth-Douglass Hospital

Compare: MRI, brain (with and without contrast) at other NH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.