CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Decatur County Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,255
  • Cash Discount Price: $3,255
  • vs. Medicare Baseline: 9.13x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Decatur County Hospital is $3,255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,255. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.13x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$3,255

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,255

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: $3,255 (913%)
Insurance Median: $3,255 (913%)
Cash: $3,255 (913% of Medicare)
Ins. Median: $3,255 (913% 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 913% of the Medicare baseline (a markup of 813%). 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
Wellmark Hmo $1,234 346%
Blue Cross Blue Shield $1,302 365%
Wellmark Ppo - All Other Plans $1,357 381%
Champva -All Plans $1,831 514%
Everystep Hospice-All Plans $2,116 594%
Aetna $2,197 - $3,215 616%
Tricare $2,197 616%
UnitedHealthcare $2,441 - $3,459 685%
Benefit Admin System-All Plans $2,645 742%
Humana $2,970 833%
Meritain Health-All Plans $2,970 833%
Misc Commercial-All Plans $2,970 833%
All Savers-All Plans $3,052 856%
Allied Benefit System-All Plans $3,052 856%
American Family Ins Grp-All Plans $3,052 856%
Rural Carrier Benefit Plan-All Plans $3,133 879%
Christian Healthcare -All Plans $3,255 913%
Medica-All Other Plans $3,255 913%
Golden Rule-All Plans $3,459 970%
Ntca The Rural Broadband-All Plans $3,459 970%
Cigna $3,499 982%
Medical Mutual-All Plans $3,581 1005%
Farm Bureau Financial-All Other Plans $3,662 1027%
Farm Bureau Property And Ca $3,662 1027%
Medi Share-All Plans $3,703 1039%
Uhss-All Plans $3,703 1039%
Health Partners-All Plans $3,743 1050%
Lewermark-All Plans $3,866 1085%
Mail Handlers Benefit-All Plans $3,988 1119%
Midlands Choice-All Plans $3,988 1119%
Priority Health-All Plans $4,069 1142%
Iowa Total Care Mcaid-All Plans $4,150 1164%
Amerigroup Mcaid-All Plans $4,272 1199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals