CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Southern Ocean Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $890
Cash Discount Price: $264
vs. Medicare Baseline: 3.65x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Southern Ocean Medical Center is $890. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.65x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$264

Average discount available for prompt cash payment at this facility.

Insurance Median

$890

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: $264 (108%)

Insurance Median: $890 (365%)

Cash: $264 (108% of Medicare)

Ins. Median: $890 (365% 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 365% of the Medicare baseline (a markup of 265%). 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
Karna	$124 - $370	51%
Blue Cross Blue Shield	$264	108%
Vaccn	$264	108%
Wellcare	$264	108%
United Community/Americhoice	$277	114%
Aetna	$288 - $3,189	118%
UnitedHealthcare	$317 - $951	130%
Cigna	$407 - $3,258	167%
Oxford	$560 - $2,203	230%
Clover	$733	301%
Seoul Medical Group	$835	343%
Amerihealth	$945 - $961	388%
Horizon	$2,652 - $3,724	1088%
Brighton Health Plan	$2,810	1153%
Multiplan - PHCS	$3,462	1420%
Qualcare	$3,698	1517%
Bergen Risk	$4,332	1777%

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 $264.
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 Southern Ocean Medical Center 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.