CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sycamore Shoals Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $343
  • Cash Discount Price: $605
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sycamore Shoals Hospital is $343. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $605. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.41x the Medicare baseline. Located in 1501 West Elk Avenue, Elizabethton, TN.
Cash / Self-Pay
$605

Average discount available for prompt cash payment at this facility.

Insurance Median
$343

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: $605 (248%)
Insurance Median: $343 (141%)
Cash: $605 (248% of Medicare)
Ins. Median: $343 (141% 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.

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
Amerigroup $215 - $216 88%
Aetna $216 - $2,573 89%
Humana $216 89%
Managed Medicaire $216 89%
Medicare (plans) $216 89%
Sentara Health $216 - $1,122 89%
United Mine Workers Of America $216 89%
UnitedHealthcare $216 - $4,033 89%
Blue Cross Blue Shield $223 - $928 91%
Molina Healthcare $225 - $343 92%
Cigna $227 - $1,025 93%
Devoted Health Plan $227 93%
Nhc Advantage $227 93%
Wellcare $229 - $4,033 94%
Optima Health $330 135%
Ambetter / Centene $472 194%
Medcost $1,412 579%
First Health Coventry $3,025 1241%
Seven Corners, Inc. $4,033 1654%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 West Elk Avenue, Elizabethton, TN 37643
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals