CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Carilion Tazewell Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,342
Cash Discount Price: $2,298
vs. Medicare Baseline: 9.38x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Carilion Tazewell Community Hospital is $3,342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,298. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.38x the Medicare baseline. Located in 388 Ben Bolt Avenue, Tazewell, VA.

Cash / Self-Pay

$2,298

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,342

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: $2,298 (645%)

Insurance Median: $3,342 (938%)

Cash: $2,298 (645% of Medicare)

Ins. Median: $3,342 (938% 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 938% of the Medicare baseline (a markup of 838%). 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
Corvel	$265	74%
Blue Cross Blue Shield	$293 - $1,842	82%
Sentara Health Plan	$299 - $4,070	84%
Aetna	$306 - $4,359	86%
Abh Of Va (Formerly Coventry)	$307	86%
Abh Of Wva (Formerly Coventry)	$307	86%
Humana	$307 - $355	86%
UnitedHealthcare	$307 - $5,366	86%
Allcare	$326	91%
Gateway - Tier 3	$3,611	1013%
Vhn - Ultra	$4,070	1142%
Cigna	$4,169 - $4,445	1170%
Connecticare	$4,596	1289%
Vhn - Plus	$5,055	1418%
Gateway - Tier 2	$5,252	1474%
Vhn	$5,252	1474%
Integrated Health Plan	$5,580	1566%
Vhn - Link	$5,908	1658%
Gateway - Tier 1	$6,237	1750%
Vhn - Secondary Payors	$6,237	1750%
National Provider Network	$6,302	1768%

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 $2,298.
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 Carilion Tazewell Community Hospital 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.