CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Spotsylvania Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,915
Cash Discount Price: $7,783
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Spotsylvania Regional Medical Center is $1,915. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,783. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.37x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.

Cash / Self-Pay

$7,783

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,915

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: $7,783 (2184%)

Insurance Median: $1,915 (537%)

Cash: $7,783 (2184% of Medicare)

Ins. Median: $1,915 (537% 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 537% of the Medicare baseline (a markup of 437%). 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	$270 - $1,156	76%
United	$828 - $3,502	232%
Lifeworks	$1,479	415%
Aetna	$1,915	537%
Virginia Health Network	$2,724 - $5,059	764%
Kaiser	$4,592	1288%
Greenvbrier Sporting Club	$4,670	1310%
Multiplan	$5,526	1550%
Corvel	$5,603	1572%
Occunet Workers Comp	$6,226	1747%
4Most Health Nework	$7,004	1965%
Three Rivers Provider Network	$7,004	1965%

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 $7,783.
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 Spotsylvania Regional 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.