CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Lonesome Pine Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $319
Cash Discount Price: $605
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Lonesome Pine Hospital is $319. 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 1.31x the Medicare baseline. Located in 1990 Holton Avenue East, Big Stone Gap, VA.

Cash / Self-Pay

$605

Average discount available for prompt cash payment at this facility.

Insurance Median

$319

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: $319 (131%)

Cash: $605 (248% of Medicare)

Ins. Median: $319 (131% 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.

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
UnitedHealthcare	$169 - $4,033	69%
Aetna	$233 - $1,722	96%
Amerigroup	$233	96%
Humana	$233	96%
Managed Medicaire	$233	96%
Medicare (plans)	$233	96%
Sentara Health	$233 - $1,021	96%
United Mine Workers Of America	$233	96%
Blue Cross Blue Shield	$240 - $4,033	98%
Cigna	$244 - $1,215	100%
Devoted Health Plan	$244	100%
Molina Healthcare	$244 - $320	100%
Mountain Empire Pace	$244	100%
Nhc Advantage	$244	100%
Wellcare	$247	101%
Optima Health	$314	129%
Ambetter / Centene	$508	208%
Seven Corners, Inc.	$559	229%
Medcost	$1,919	787%
First Health Coventry	$3,630	1489%

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 $605.
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 Lonesome Pine 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.