CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Porter Hospital Inc

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $316
Cash Discount Price: $2,032
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Porter Hospital Inc is $316. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,032. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.30x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$2,032

Average discount available for prompt cash payment at this facility.

Insurance Median

$316

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: $2,032 (834%)

Insurance Median: $316 (130%)

Cash: $2,032 (834% of Medicare)

Ins. Median: $316 (130% 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.

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
UnitedHealthcare	$46 - $3,660	19%
Mvp	$56 - $3,446	23%
Fidelis Care	$59 - $1,564	24%
Humana	$63 - $230	26%
Aetna	$66 - $1,738	27%
Capital District Physicians' Health Plan	$66 - $3,083	27%
Martins Point	$66 - $1,738	27%
Veterans Affairs Community Care Network	$66 - $1,738	27%
Veterans Choice	$66 - $1,738	27%
Blue Cross Blue Shield	$76 - $3,483	31%
Harvard Pilgrim	$77 - $2,958	32%
Coventry	$86 - $3,253	35%
Cigna	$96 - $3,362	39%
Wellpath	$202 - $2,033	83%
Medical Corporation	$349 - $3,512	143%
Multiplan	$349 - $3,512	143%

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 $2,032.
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 Porter Hospital 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.