CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Robert Wood Johnson University Hospital at Hamilton

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $414
Cash Discount Price: $537
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Robert Wood Johnson University Hospital at Hamilton is $414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $537. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.70x the Medicare baseline. Located in One Hamilton Health Place, Hamilton, NJ.

Cash / Self-Pay

$537

Average discount available for prompt cash payment at this facility.

Insurance Median

$414

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: $537 (220%)

Insurance Median: $414 (170%)

Cash: $537 (220% of Medicare)

Ins. Median: $414 (170% 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.

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
Aetna	$264 - $437	108%
Blue Cross Blue Shield	$264 - $2,787	108%
Clover Health	$264	108%
Fidelis Care	$264 - $410	108%
Humana	$264	108%
Wellpoint	$264	108%
UnitedHealthcare	$269 - $399	110%
Cigna	$327 - $437	134%
Emblem Health	$462	190%
Wellcare	$526	216%
Amerihealth	$618 - $664	254%
First Health	$1,967	807%
Qualcare Inc	$3,493	1433%

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 $537.
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 Robert Wood Johnson University Hospital at Hamilton 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.