CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lewisgale Hospital Montgomery

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $4,604
Cash Discount Price: $7,673
vs. Medicare Baseline: 12.92x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lewisgale Hospital Montgomery is $4,604. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,673. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 12.92x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$7,673

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,604

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: $7,673 (2153%)

Insurance Median: $4,604 (1292%)

Cash: $7,673 (2153% of Medicare)

Ins. Median: $4,604 (1292% 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 1292% of the Medicare baseline (a markup of 1192%). 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
Blue Cross Blue Shield	$444 - $1,533	125%
United	$828 - $3,453	232%
Cigna	$1,335	375%
Lifeworks	$1,458	409%
Universal Healthcare Group	$1,688	474%
Virginia Health Network	$2,686 - $5,448	754%
Aetna	$2,994 - $4,644	840%
Greenvbrier Sporting Club	$4,604	1292%
Corvel	$5,525	1550%
Richfield Nursing Center	$5,755	1615%
Richfield Retirement Community	$5,755	1615%
Multiplan	$5,908	1658%
Community Care Network	$6,138	1722%
Graham-White Manufacturing	$6,138	1722%
Occunet Workers Comp	$6,138	1722%
One Health Plan	$6,138	1722%
Phcs	$6,522	1830%
Patients Choice	$6,752	1894%
4Most	$6,906	1938%
American Postal Workers Union	$6,906	1938%
Star Transportation	$6,906	1938%

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 $7,673.
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 Lewisgale Hospital Montgomery 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.