CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Wheeling Hospital, Inc

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $237
Cash Discount Price: $1,443
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Wheeling Hospital, Inc is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,443. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.97x the Medicare baseline. Located in 1 Medical Park, Wheeling, WV.

Cash / Self-Pay

$1,443

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $1,443 (592%)

Insurance Median: $237 (97%)

Cash: $1,443 (592% of Medicare)

Ins. Median: $237 (97% 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
Highmark Health Options West Va	$52	21%
Wellpoint West Virginia	$52	21%
Aetna	$53 - $241	22%
The Health Plan Wv	$53	22%
Medicaid / KanCare	$149	61%
Blue Cross Blue Shield	$230 - $942	94%
Buckeye Commercial	$230	94%
Medicare (plans)	$230 - $243	94%
Humana	$241	99%
Senior Life Pa - Ma	$241	99%
UnitedHealthcare	$250	103%
Geisinger Pennsylvania	$269	110%
Pennsylvania Health & Wellness	$269	110%

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 $1,443.
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 Wheeling 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.