CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Madison County Health Care System

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,272
Cash Discount Price: $2,796
vs. Medicare Baseline: 9.32x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Madison County Health Care System is $2,272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,796. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.32x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.

Cash / Self-Pay

$2,796

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,272

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: $2,796 (1147%)

Insurance Median: $2,272 (932%)

Cash: $2,796 (1147% of Medicare)

Ins. Median: $2,272 (932% 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 932% of the Medicare baseline (a markup of 832%). 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
Blue Cross Blue Shield	$983 - $1,082	403%
Aetna	$1,503 - $2,272	617%
Medical Associates Hp - All Plans	$1,503	617%
Medigold-All Plans	$1,503	617%
Tricare	$1,503	617%
UnitedHealthcare	$1,503 - $3,146	617%
American Hp Mcr Adv-All Plans	$1,578	647%
Iowa Total Care Mcaid-All Plans	$1,643	674%
Molina Mcaid/Chip -All Plans	$1,700	697%
Amerigroup Mcaid-All Plans	$1,741	714%
Madison County Sheriff-All Plans	$1,748	717%
Oscar - All Plans	$2,254	925%
Corvel Wc-All Plans	$3,146	1291%
Choicecare-All Plans	$3,320	1362%
First Choice-All Plans	$3,320	1362%
First Health-All Plans	$3,320	1362%
Integrated Hp-All Plans	$3,320	1362%
Mutual Of Omaha-All Plans	$3,320	1362%
Plaines Health-All Plans	$3,320	1362%
Preferred Hlth Ntwork-All Plans	$3,320	1362%
Principal Healthcare-All Plans	$3,320	1362%
Usa Managed Care-All Plans	$3,320	1362%
Medimore Employee Hp - All Plans	$3,425	1405%
Midlands Choice - All Plans	$3,425	1405%
Benefit Admin Of America-All Plans	$3,495	1434%

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 $2,796.
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 Madison County Health Care System 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.