CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $4,065
Cash Discount Price: $4,700
vs. Medicare Baseline: 16.68x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Childrens Hospital of the Kings Daughters Inc is $4,065. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,700. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 16.68x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$4,700

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,065

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: $4,700 (1928%)

Insurance Median: $4,065 (1668%)

Cash: $4,700 (1928% of Medicare)

Ins. Median: $4,065 (1668% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1668% of the Medicare baseline (a markup of 1568%). 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	$358 - $820	147%
UnitedHealthcare	$360 - $4,292	148%
Sentara Community Plan	$421	173%
Aetna	$442 - $41,100	181%
Humana	$442	181%
Amerihealth Caritas	$1,201	493%
Healthy Blue	$1,201	493%
Carolina Complete Health	$1,225	503%
Wellcare	$1,237	507%
Sentara Health Plans	$1,877	770%
Cigna	$3,467	1422%
Virginia Health Network	$3,655 - $4,177	1499%
Medcost	$4,438 - $4,804	1821%
First Health	$4,700	1928%
Multiplan	$4,804	1971%
Phcs	$4,804 - $4,961	1971%
Vhn	$4,804 - $4,961	1971%
Johns Hopkins Healthcare	$4,961	2035%

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 $4,700.
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 Childrens Hospital of the Kings Daughters Inc 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.