CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $5,355
Cash Discount Price: $6,191
vs. Medicare Baseline: 15.02x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Childrens Hospital of the Kings Daughters Inc is $5,355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,191. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 15.02x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$6,191

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,355

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: $6,191 (1737%)

Insurance Median: $5,355 (1502%)

Cash: $6,191 (1737% of Medicare)

Ins. Median: $5,355 (1502% 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 1502% of the Medicare baseline (a markup of 1402%). 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	$602 - $1,199	169%
UnitedHealthcare	$606 - $5,654	170%
Sentara Community Plan	$709	199%
Aetna	$743 - $41,100	208%
Humana	$743	208%
Amerihealth Caritas	$1,582	444%
Healthy Blue	$1,582	444%
Carolina Complete Health	$1,614	453%
Wellcare	$1,630	457%
Sentara Health Plans	$2,037	572%
Cigna	$4,568	1282%
Virginia Health Network	$4,815 - $5,503	1351%
Medcost	$5,847 - $6,328	1640%
First Health	$6,191	1737%
Multiplan	$6,328	1775%
Phcs	$6,328 - $6,535	1775%
Vhn	$6,328 - $6,535	1775%
Johns Hopkins Healthcare	$6,535	1833%

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 $6,191.
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 Childrens Hospital of the Kings Daughters Inc 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.