CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Mercyone Elkader Medical Center

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,601
Cash Discount Price: $2,297
vs. Medicare Baseline: 10.67x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Mercyone Elkader Medical Center is $2,601. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,297. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.67x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.

Cash / Self-Pay

$2,297

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,601

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: $2,297 (942%)

Insurance Median: $2,601 (1067%)

Cash: $2,297 (942% of Medicare)

Ins. Median: $2,601 (1067% 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 1067% of the Medicare baseline (a markup of 967%). 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
Aetna	$1,838 - $2,601	754%
Medicare (plans)	$1,856 - $1,909	761%
UnitedHealthcare	$1,948 - $2,650	799%
Iowa Total Care	$2,199	902%
Medicaid / KanCare	$2,231 - $2,242	915%
Amish Hospital Aid	$2,444	1003%
1199 National Benefit Fund	$2,601	1067%
Allied Benefit Systems	$2,601	1067%
Asr Health Benefits	$2,601	1067%
Christian Brother Services	$2,601	1067%
Coventry	$2,601	1067%
First Health	$2,601	1067%
Lucent Health	$2,601	1067%
Luminare Health	$2,601	1067%
Medical Mutual	$2,601	1067%
Meritain	$2,601	1067%
Trustmark Small Business Benefits	$2,601	1067%
Webtpa	$2,601	1067%
Geha	$2,650	1087%
Centivo	$2,757	1131%
Health Choices	$2,827	1160%
Medical Associates	$2,827	1160%
Health Partners	$3,400	1395%
Auxiant	$3,463	1421%
Cigna	$3,463	1421%
Medica	$3,463	1421%
Midlands	$3,463	1421%
Midlands Choice	$3,463	1421%
Crime Victim Assistance	$3,534	1450%
Iowa Dept Of Public Health	$3,534	1450%
Claimdoc	$3,694	1515%
Nova	$3,694	1515%

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 $2,297.
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 Mercyone Elkader Medical Center 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.