CMS Price Transparency Data

MRI, brain (no contrast)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,697
Cash Discount Price: $4,139
vs. Medicare Baseline: 6.96x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at St Anthony Regional Hospital & Nursing Home is $1,697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,139. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.96x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$4,139

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,697

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: $4,139 (1698%)

Insurance Median: $1,697 (696%)

Cash: $4,139 (1698% of Medicare)

Ins. Median: $1,697 (696% 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 696% of the Medicare baseline (a markup of 596%). 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
Wellmark Hmo	$691	283%
Wellmark Ppo-All Other Plans	$760	312%
Aetna	$1,490 - $3,725	611%
Humana	$1,490 - $3,518	611%
Medica Mcr - All Plans	$1,490	611%
UnitedHealthcare	$1,490 - $3,336	611%
Va Ccn - All Plans	$1,490	611%
Wellpoint Mcr Adv	$1,490	611%
Ia Total Care Mcr	$1,535	630%
Ia Total Care Mcaid	$1,697	696%
Wellpoint Mcaid - All Other Plans	$1,697	696%
Molina Mcaid - All Plans	$1,731	710%
Ia Total Care Comm - All Other Plans	$1,937	795%
Midlands Choice - All Plans	$3,891	1596%

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 $4,139.
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 St Anthony Regional Hospital & Nursing Home 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.