CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Kosciusko Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $1,755
  • Cash Discount Price: $1,074
  • vs. Medicare Baseline: 4.92x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Kosciusko Community Hospital is $1,755. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,074. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.92x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$1,074

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,755

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: $1,074 (301%)
Insurance Median: $1,755 (492%)
Cash: $1,074 (301% of Medicare)
Ins. Median: $1,755 (492% 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 492% of the Medicare baseline (a markup of 392%). 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
Veterans Eval Services $329 92%
UnitedHealthcare $350 - $4,463 98%
Tricare $351 98%
Department Of Veterans Affairs $369 104%
Aetna $389 - $4,711 109%
Blue Cross Blue Shield $389 - $1,517 109%
Humana $389 - $756 109%
Medicare (plans) $389 109%
Mhs $389 - $756 109%
Iu Health $395 111%
Node Non Par Hospice Agree $395 111%
Node Va $395 111%
Node Devoted Health Mcr Adv $397 111%
In Dept Of Correction $411 115%
Node Pphp Mcr Adv $415 116%
Us Department Of Labor $494 139%
Amish Aid $567 - $1,860 159%
Self Pay $567 - $3,453 159%
Caresource $582 - $756 163%
Lutheran Advanced Network $593 166%
Lutheran Preferred $593 - $791 166%
Align In Work Comp $633 178%
One Call Work Comp $633 178%
One Call Care Diagnostics Wc $700 196%
Encore Work Comp In $712 200%
Prime Health Services $712 - $6,641 200%
Managed Health Services $756 212%
Medicaid / KanCare $756 212%
Managed Health Services Exchange $791 222%
Workers Comp $791 222%
Lutheran Preferred Network $853 - $7,084 239%
Encore Kba Epo $949 266%
Physicians Health Plan $996 - $4,080 279%
Php Freedom Network $1,043 - $3,420 293%
Encore $1,080 - $3,542 303%
Trma Inc $1,080 - $3,985 303%
Encore Kba Ppo $1,186 333%
Connecticut General Life Insurance Company $1,590 - $5,216 446%
Cigna $1,706 - $5,596 479%
First Health Network $2,025 - $6,641 568%
Advantage Health $2,241 - $7,350 629%
Private Healthcare Systems $2,322 - $7,615 651%
Sagamore $2,376 - $8,324 667%
Encore Health Network $2,511 - $8,235 704%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals