CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Tristar Summit Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $773
Cash Discount Price: $10,643
vs. Medicare Baseline: 3.17x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Tristar Summit Medical Center is $773. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,643. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.17x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$10,643

Average discount available for prompt cash payment at this facility.

Insurance Median

$773

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: $10,643 (4366%)

Insurance Median: $773 (317%)

Cash: $10,643 (4366% of Medicare)

Ins. Median: $773 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Humana	$276 - $6,918	113%
United	$314 - $4,789	129%
Blue Cross Blue Shield	$454 - $844	186%
Aetna	$541 - $5,322	222%
Kentucky Labor Cabinet	$1,959	804%
Apex Health	$2,022	829%
Nhc Advantage, Inc.	$2,022	829%
Pruitt Health (Allyalign)	$2,022	829%
Cigna	$3,470 - $8,515	1423%
Bgfh Singlesource	$5,322 - $9,047	2183%
Multiplan	$6,918	2838%
Employers Health Network	$7,450	3056%
Beech Street	$9,366	3842%
Prime Health	$9,366	3842%

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 $10,643.
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 Tristar Summit 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.