CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Spencer Municipal Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,929
  • Cash Discount Price: $1,702
  • vs. Medicare Baseline: 7.91x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Spencer Municipal Hospital is $1,929. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,702. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.91x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$1,702

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,929

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: $1,702 (698%)
Insurance Median: $1,929 (791%)
Cash: $1,702 (698% of Medicare)
Ins. Median: $1,929 (791% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 791% of the Medicare baseline (a markup of 691%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicare (plans) $203 - $205 83%
UnitedHealthcare $203 - $2,043 83%
Humana $205 - $2,156 84%
Medicaid / KanCare $228 94%
Wellmark Hmo $806 331%
Wellmark Ppo $885 363%
Healthpartners (All) $1,816 745%
Midlands Choice - Ilcc $1,929 791%
Midlands Choice - Morton Bldg $1,929 791%
Coventry - Commercial Hmo $2,043 838%
Avera Health Plan $2,156 884%
Coventry - Commercial Ppo $2,156 884%
First Choice Of Midwest $2,156 884%
Midlands Choice (All Others) $2,156 884%
Sanford Health $2,156 884%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals