CMS Price Transparency Data

MRI, brain (no contrast)

Facility: St Marys Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $224
Cash Discount Price: $3,623
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at St Marys Medical Center is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,623. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.92x the Medicare baseline. Located in 2900 1St Avenue, Huntington, WV.

Cash / Self-Pay

$3,623

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $3,623 (1486%)

Insurance Median: $224 (92%)

Cash: $3,623 (1486% of Medicare)

Ins. Median: $224 (92% 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
The Healthplan	$53 - $132	22%
Unicare	$53 - $132	22%
Aetna	$67 - $3,261	27%
Blue Cross Blue Shield	$67 - $1,689	27%
Humana	$67 - $242	27%
Peak Health	$67 - $3,080	27%
Peia	$67 - $268	27%
UnitedHealthcare	$67 - $3,428	27%
Caresource	$73 - $3,442	30%
Medicare (plans)	$242	99%
Cigna	$3,297	1353%
Firsthealth	$3,442	1412%
Healthsmart	$3,442	1412%
Phcs Multiplan	$3,442	1412%
Zelis Network	$3,442	1412%

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 $3,623.
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 St Marys Medical Center 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.