CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Nationwide Children's Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $877
Cash Discount Price: $2,286
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Nationwide Children's Hospital is $877. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,286. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.60x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$2,286

Average discount available for prompt cash payment at this facility.

Insurance Median

$877

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: $2,286 (938%)

Insurance Median: $877 (360%)

Cash: $2,286 (938% of Medicare)

Ins. Median: $877 (360% 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 360% of the Medicare baseline (a markup of 260%). 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
Aetna	$79 - $2,413	32%
Caresource	$100 - $392	41%
Humana	$159 - $2,413	65%
Ohio Ppo Connect	$197 - $2,362	81%
Osu	$197 - $2,362	81%
UnitedHealthcare	$198 - $2,413	81%
Blue Cross Blue Shield	$218 - $2,388	89%
Tricare	$244	100%
Mmo	$251 - $2,388	103%
Cigna	$262 - $2,388	107%
Front Path Health Coalition	$262 - $2,388	107%
Ohc	$262 - $2,362	107%
Ohg	$262 - $2,286	107%
The Health Plan	$262 - $2,438	107%
Amerihealth	$392	161%
Bchp	$392	161%
Molina	$392	161%
Ahpo	$2,388	980%
Unicare	$2,413	990%
Emerald Health	$2,489	1021%
First Health	$2,489	1021%
Phcs	$2,489	1021%

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 $2,286.
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 Nationwide Children's Hospital 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.