CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Dallas County Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,170
  • Cash Discount Price: $4,248
  • vs. Medicare Baseline: 8.89x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Dallas County Hospital is $3,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,248. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.89x the Medicare baseline. Located in 610 Tenth Street, Perry, IA.
Cash / Self-Pay
$4,248

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,170

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: $4,248 (1192%)
Insurance Median: $3,170 (889%)
Cash: $4,248 (1192% of Medicare)
Ins. Median: $3,170 (889% 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 889% of the Medicare baseline (a markup of 789%). 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) $288 - $2,946 81%
Aetna $2,946 827%
Humana $2,946 827%
UnitedHealthcare $3,007 - $5,556 844%
Amerigroup Wellpoint $3,333 935%
Iowa Total Care Mcd Adv (Active 7/1/19) $3,333 935%
Medicaid / KanCare $3,333 935%
Molina Healthcare Of Iowa Mcd Rep $3,333 935%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 610 Tenth Street, Perry, IA 50220
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals