CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Washington Hospital, The

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $500
Cash Discount Price: $1,500
vs. Medicare Baseline: 2.05x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Washington Hospital, The is $500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,500. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.05x the Medicare baseline. Located in 155 Wilson Avenue, Washington, PA.

Cash / Self-Pay

$1,500

Average discount available for prompt cash payment at this facility.

Insurance Median

$500

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: $1,500 (615%)

Insurance Median: $500 (205%)

Cash: $1,500 (615% of Medicare)

Ins. Median: $500 (205% 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 205% of the Medicare baseline (a markup of 105%). 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
Upmc Health Plan	$173 - $819	71%
Blue Cross Blue Shield	$214 - $531	88%
Aetna	$230 - $1,325	94%
Senior Life	$230	94%
Humana	$233	96%
Health Plan Of Upper Ohio Valley	$235 - $1,638	96%
Highmark Wholecare (Prev Gateway)	$243 - $388	100%
Amerihealth Caritas	$388	159%
City Of Washington	$461	189%
Cigna	$1,444	592%
Peak Health	$1,554 - $1,687	637%
Coventry/First Health	$1,599 - $1,735	656%

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 $1,500.
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 Washington Hospital, The 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.