CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lewisgale Hospital Pulaski

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $6,944
Cash Discount Price: $13,226
vs. Medicare Baseline: 19.48x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lewisgale Hospital Pulaski is $6,944. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,226. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 19.48x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.

Cash / Self-Pay

$13,226

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,944

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: $13,226 (3711%)

Insurance Median: $6,944 (1948%)

Cash: $13,226 (3711% of Medicare)

Ins. Median: $6,944 (1948% 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 1948% of the Medicare baseline (a markup of 1848%). 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	$367 - $1,266	103%
United	$828 - $5,952	232%
Lifeworks	$2,513	705%
Universal Healthcare Group	$2,910	816%
Aetna	$2,994 - $5,952	840%
Virginia Health Network	$4,629 - $9,390	1299%
Greenvbrier Sporting Club	$7,936	2227%
Corvel	$9,523	2672%
Richfield Nursing Center	$9,920	2783%
Richfield Retirement Community	$9,920	2783%
Multiplan	$10,184	2857%
Community Care Network	$10,581	2969%
Graham-White Manufacturing	$10,581	2969%
Occunet Workers Comp	$10,581	2969%
One Health Plan	$10,581	2969%
Patients Choice	$11,639	3265%
4Most	$11,903	3340%
American Postal Workers Union	$11,903	3340%
Phcs	$11,903	3340%
Star Transportation	$11,903	3340%

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 $13,226.
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 Pulaski 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.