CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Vidant Chowan Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $4,575
Cash Discount Price: $4,047
vs. Medicare Baseline: 12.84x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Vidant Chowan Hospital is $4,575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,047. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 12.84x the Medicare baseline. Located in 211 Virginia Rd, Edenton, NC.

Cash / Self-Pay

$4,047

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,575

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: $4,047 (1135%)

Insurance Median: $4,575 (1284%)

Cash: $4,047 (1135% of Medicare)

Ins. Median: $4,575 (1284% 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 1284% of the Medicare baseline (a markup of 1184%). 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	$2,170 - $4,387	609%
Carolina Complete Health [1317]	$2,191	615%
Wellcare [1320]	$2,202	618%
Amerihealth McAid Adv [1316]	$2,213	621%
Humana	$2,240	628%
UnitedHealthcare	$2,436 - $4,452	683%
Liberty Advantage [1313]	$2,508	704%
Aetna	$2,580 - $5,912	724%
Longevity Health [1411]	$3,100	870%
Nc Dept of Public Safety [1095]	$4,047	1135%
Medcost [1067]	$4,575 - $4,820	1284%
Cigna	$6,143 - $6,866	1723%
Multiplan [1031]	$6,866	1926%

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 $4,047.
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 Vidant Chowan Hospital 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.