CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Lehigh Valley Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $504
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.07x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Lehigh Valley Hospital is $504. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.07x the Medicare baseline. Located in 1200 South Cedar Crest Boulevard, Allentown, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$504

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%)

Insurance Median: $504 (207%)

Ins. Median: $504 (207% 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 207% of the Medicare baseline (a markup of 107%). 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
Cigna	$214 - $719	88%
Amerihealth	$252 - $260	103%
Blue Cross Blue Shield	$252 - $1,907	103%
Ibc	$252 - $2,960	103%
UnitedHealthcare	$252 - $857	103%
Highmark Blue Shield	$257 - $815	105%
Geisinger	$260 - $1,108	107%
Aetna	$265 - $1,398	109%
Jefferson Health Partners	$265 - $504	109%
Devoted Health	$267	110%
Humana	$267	110%
Upmc	$267 - $1,228	110%
Gateway	$270	111%
Emblem	$272 - $1,125	112%
Pa Health & Wellness (Allwell)	$277	114%
Amerihealth Caritas	$371 - $608	152%
Highmark Wholecare/Gateway	$429	176%
Pa Health & Wellness	$456	187%
Keystone First	$490	201%
Ambetter / Centene	$765	314%
Valley Preferred	$1,470	603%

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 $X.
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 Lehigh Valley 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.