CPT70553

MRI Brain Cost in North Carolina

Mri brain stem w/o & w/dye

$673Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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North Carolina Medicare physician rate (2026)

-5.6% vs national

Single statewide locality.

North Carolina (Hospital)
$299.16
Facility physician fee
Private plan est.
$389–$598
~130–200% of Medicare
Cash / self-pay est.
$239–$449
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$510
$317 physician + $193 facility
Physician fee alone
$317
Only 47% of the hospital total

Choosing a surgery centre over a hospital saves about $164 on the Medicare allowed amount for mri brain. Ask whether your procedure can be done at an ambulatory surgery centre.

Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in North Carolina

Check your ZIP code for your region of North Carolina, whether Charlotte, Raleigh-Durham and the Triangle, the Triad, Asheville and the mountains, or Wilmington and the coastal east.

What mri brain costs at hospitals near you

Everything above is a national average. The hospital you pick in North Carolina moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.

National vs North Carolina

National office$316.97
National hospital (physician)$316.97
North Carolina vs national6% below the national office rate of $316.97

Where North Carolina ranks for this CPT

Rank (lowest physician fee first)#18 of 51
Lowest stateArkansas ($280.94)
Highest stateAlaska ($367.23)

MRI Brain and how North Carolina is priced

North Carolina's Medicare physician pricing comes from one statewide locality with indices just under the national average, so Charlotte, the Research Triangle, and the rural east and mountain west all share the same approved amounts. For a state with several fast-growing metros, the single-locality approach keeps the fee schedule simple even as local economies diverge. Nothing in the geographic adjustments distinguishes a Raleigh procedure from one in Boone or Greenville. As elsewhere, the office-versus-hospital setting decision moves prices more than geography within the state does.

North Carolina is unusually rich in academic medicine, with multiple nationally known university medical centers clustered in the Triangle and Winston-Salem, plus a major hospital system anchored in Charlotte that has grown across the Southeast. The rural east and the mountain counties are much thinner markets, and hospital consolidation has been reshaping who owns local care. Patients near the borders sometimes use Virginia or South Carolina providers.

This procedure: This is the most complete brain MRI protocol: the scanner first takes a full set of images without dye, then repeats key sequences after an IV gadolinium injection, letting the radiologist compare the two. It is the standard workup for suspected brain tumors, multiple sclerosis, pituitary problems, and infection. Plan for 45 to 60 minutes in the scanner with an IV in your arm, making it the longest and most expensive of the three brain MRI codes.

What Is MRI Brain?

This is the most complete brain MRI protocol: the scanner first takes a full set of images without dye, then repeats key sequences after an IV gadolinium injection, letting the radiologist compare the two. It is the standard workup for suspected brain tumors, multiple sclerosis, pituitary problems, and infection. Plan for 45 to 60 minutes in the scanner with an IV in your arm, making it the longest and most expensive of the three brain MRI codes.

What Affects the Cost

  • As the combined protocol, 70553 carries the highest base price of the brain MRI family, before facility markup differences.
  • Hospital imaging departments charge far more than independent centers for this long scan.
  • The gadolinium dose is a separate supply charge on top of the imaging codes.
  • Longer scanner time means claustrophobia or movement problems are more likely to require sedation or a rescan, each adding cost.
  • Follow-up MRIs to track a finding over time repeat the full cost at each interval, so the surveillance schedule matters as much as the single-scan price.

Questions to Ask Before Booking

  • 1.Was the full without-and-with-contrast protocol authorized, or only a plain MRI?
  • 2.What is your global price for this study at a freestanding center?
  • 3.How many follow-up scans is my condition likely to need, and at what interval?
  • 4.Are the contrast agent and radiologist reading included in the quoted price?
  • 5.If my insurer pushes back, will my doctor do a peer-to-peer review to defend this protocol?

MRI Brain in North Carolina: questions

North Carolina is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 70553 is $299.16 in an office and $299.16 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. North Carolina uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $60 for the office physician line or $60 for the hospital physician line in North Carolina. Medigap may cover that 20%. This is not the hospital facility fee.

No. $299.16 is only the physician's share. Adding Medicare's facility payment brings the total to about $673 in a hospital outpatient department, or about $510 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. North Carolina ranks #18 of 51 states on the physician line (6% below the national office rate of $316.97).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.