Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
MRI HEAD W&WO CONTRAST
Winston-Salem, NC
See all hospitals reporting CPT 70553 →Price type
Forsyth Memorial Hospital, Inc.’s median price of $744 is 15% below the median hospital's median price ($871), higher than 44% of the 2,597 hospitals reporting CPT 70553. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 29 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Blue Cross Blue Shield blue medicare fee schedule · outpatient | $338.36 | $338.36 | $338.36 – $338.36 |
| 2 | Humana medicare fee schedule · outpatient | $338.36 | $338.36 | $338.36 – $338.36 |
| 3 | UnitedHealthcare medicare fee schedule · outpatient | $338.36 | $338.36 | $338.36 – $338.36 |
| 4 | Aetna medicare fee schedule · outpatient | $346.82 | $346.82 | $346.82 – $346.82 |
| 5 | Cigna healthspring fee schedule · outpatient | $348.51 | $348.51 | $348.51 – $348.51 |
| 6 | Blue Cross Blue Shield healthy blue medicaid fee schedule · outpatient | $692.16 | $692.16 | $640.36 – $743.96 |
| 7 | UnitedHealthcare medicaid fee schedule · outpatient | $692.16 | $692.16 | $640.36 – $743.96 |
| 8 | WellCare medicaid fee schedule · outpatient | $692.16 | $692.16 | $640.36 – $743.96 |
| 9 | Cigna aca fee schedule · outpatient | $1,414 | $1,414 | $1,308 – $1,520 |
| 10 | Caresource qualified health plan fee schedule · outpatient | $1,462 | $1,462 | $1,352 – $1,571 |
| 11 | Blue Cross Blue Shield blue home fee schedule · outpatient | $1,908 | $1,908 | $1,765 – $2,050 |
| 12 | Blue Cross Blue Shield blue value fee schedule · outpatient | $1,973 | $1,973 | $1,826 – $2,121 |
| 13 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $2,014 | $2,014 | $2,014 – $2,014 |
| 14 | Cigna commercial fee schedule · outpatient | $2,171 | $2,171 | $2,008 – $2,333 |
| 15 | Aetna commercial fee schedule · outpatient | $2,251 | $2,251 | $2,083 – $2,420 |
| 16 | UnitedHealthcare all payer fee schedule · outpatient | $2,459 | $2,459 | $2,275 – $2,644 |
| 17 | Blue Cross Blue Shield hmo fee schedule · outpatient | $2,511 | $2,511 | $2,323 – $2,699 |
| 18 | Blue Cross Blue Shield ppo fee schedule · outpatient | $2,511 | $2,511 | $2,323 – $2,699 |
| 19 | Humana commercial fee schedule · outpatient | $2,847 | $2,847 | $2,634 – $3,060 |
| 20 | Aetna aca fee schedule · outpatient | $2,924 | $2,924 | $2,705 – $3,142 |
| 21 | Aetna first health fee schedule · outpatient | $2,924 | $2,924 | $2,705 – $3,142 |
| 22 | Aetna non-par products of apcn fee schedule · outpatient | $2,924 | $2,924 | $2,705 – $3,142 |
| 23 | Aetna rental network products fee schedule · outpatient | $2,924 | $2,924 | $2,705 – $3,142 |
| 24 | Aetna whole health non-multitier fee schedule · outpatient | $2,924 | $2,924 | $2,705 – $3,142 |
| 25 | Medcost mbs fee schedule · outpatient | $3,106 | $3,106 | $2,874 – $3,339 |
Last updated: Mar 30, 2026
See MRI brain and brainstem without and with contrast dye pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.