CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Charleston Area Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $6,140
Cash Discount Price: $7,343
vs. Medicare Baseline: 17.23x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Charleston Area Medical Center is $6,140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,343. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 17.23x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$7,343

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,140

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: $7,343 (2060%)

Insurance Median: $6,140 (1723%)

Cash: $7,343 (2060% of Medicare)

Ins. Median: $6,140 (1723% 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 1723% of the Medicare baseline (a markup of 1623%). 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
Aetna	$169 - $7,809	47%
The Health Plan Of West Virginia Inc.	$169 - $7,729	47%
Unicare Health Plan Of West Virginia Inc.	$169	47%
Triwest Va	$346	97%
Blue Cross Blue Shield	$356 - $7,266	100%
Choicecare Network	$356 - $7,809	100%
Optimum Choice Inc.	$356	100%
UnitedHealthcare	$367 - $7,809	103%
West Virginia Senior Advantage Inc.	$374	105%
Integrated Medical Solutions	$695	195%
Naphcare	$713	200%
Caresource	$891	250%
Tricare	$3,798 - $4,781	1066%
City Of Charleston	$4,748 - $5,976	1332%
Cigna	$5,887 - $7,410	1652%
Three Rivers Providers Network	$6,140 - $7,729	1723%
Healthsmart	$6,203 - $7,809	1740%
Multiplan	$6,203 - $7,809	1740%

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 $7,343.
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 Charleston Area 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.