CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Uva Health Culpeper Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,222
Cash Discount Price: $2,245
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Uva Health Culpeper Medical Center is $1,222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,245. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.43x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$2,245

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,222

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $2,245 (630%)

Insurance Median: $1,222 (343%)

Cash: $2,245 (630% of Medicare)

Ins. Median: $1,222 (343% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 343% of the Medicare baseline (a markup of 243%). 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
Champva [50002]	$223 - $228	63%
Tricare	$223 - $228	63%
Blue Ridge Pace [10510]	$315	88%
Medicaid / KanCare	$315	88%
Aetna	$350 - $3,094	98%
Blue Cross Blue Shield	$350 - $1,045	98%
Cigna	$350 - $2,454	98%
HMO Part B [10099]	$350	98%
Humana	$350 - $368	98%
Medicare (plans)	$350 - $361	98%
UnitedHealthcare	$350 - $5,134	98%
VA Ccn [99926]	$350 - $361	98%
VA Ccn [99927]	$350 - $361	98%
Veterans Administration [99910]	$361	101%
Geha [40009]	$1,968 - $3,649	552%
Carefirst [30007]	$2,782 - $3,388	781%
Beacon Health Options [40012]	$3,412	957%
Multiplan Generic [40035]	$3,412 - $5,800	957%
Vhn Generic [40040]	$3,412 - $5,800	957%
Sentara Behavioral Health [40052]	$3,488	979%
Sentara [40021]	$3,488	979%
Commercial Contracted Hb Only [40056]	$3,583	1005%
Commercial Generic [40000]	$3,583 - $4,777	1005%
Kaiser Permenente [40014]	$4,040	1133%
Commercial Contracted Tpa [40055]	$4,094 - $4,777	1149%
Umwa [40037]	$4,777	1340%
Healthsmart [40013]	$5,118	1436%
First Health Generic [40033]	$5,596	1570%
Gateway Health Alliance [40034]	$5,800	1627%
Onenet Workers Comp Generic [60010]	$5,978	1677%

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 $2,245.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Uva Health Culpeper Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
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.