MRI, brain (with and without contrast)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $351
- Cash Discount Price: $3,791
- vs. Medicare Baseline: 0.98x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $183 - $341 | 51% |
| Medicaid / KanCare | $183 - $348 | 51% |
| Aetna | $183 - $4,957 | 51% |
| Blue Cross Blue Shield | $207 - $665 | 58% |
| UnitedHealthcare | $304 - $3,931 | 85% |
| Pace Of The Ozarks Contracted [320518] | $341 | 96% |
| Dept Of Veteran Affairs Contracted [320106] | $341 | 96% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $341 | 96% |
| Halo Hcr Inc Hospice Contracted [320432] | $341 | 96% |
| Tricare | $341 | 96% |
| Mercy Hospice Okc [20252] | $341 | 96% |
| Elara Caring Aspire Hospice [20433] | $341 | 96% |
| Cross Timbers Hospice [20098] | $341 | 96% |
| Medicare (plans) | $341 - $355 | 96% |
| Halo Hcr Inc Hospice [20432] | $341 | 96% |
| Kindful Hospice Contracted [320434] | $341 | 96% |
| Kindful Hospice [20434] | $341 | 96% |
| Home State Health Plan Contracted [320187] | $348 | 98% |
| Ambetter / Centene | $348 | 98% |
| Providrs Care Network Contracted [320484] | $661 | 185% |
| Health Choice Contracted [320166] | $982 | 276% |
| Medica Contracted [320239] | $1,101 | 309% |
| Cigna | $1,722 - $1,766 | 483% |
| United Medical Resources Contracted [320454] | $3,931 | 1103% |
| Imagine 360 Contracted [320494] | $4,666 | 1309% |
| Edison Health Solutions Contracted [320502] | $4,666 | 1309% |
| American Healthcare Alliance Contracted [320020] | $4,666 | 1309% |
| Workers Comp [20426] | $4,666 | 1309% |
| Reflect Health Contracted [320492] | $4,666 | 1309% |
| Healthlink Contracted [320179] | $4,666 | 1309% |
| Ebms Contracted [320493] | $4,666 | 1309% |
| Mercy Benefit Admin Contracted [320251] | $4,666 | 1309% |
| Aither Health Contracted [320449] | $4,666 | 1309% |
| Yuzu Health Contracted [320521] | $4,666 | 1309% |
| Auxiant Contracted [320462] | $4,666 | 1309% |
| First Health Contracted [320128] | $4,957 | 1391% |
Consumer Guidance & Cost Commentary
Mercy Hospital Pittsburg, Inc., located at 1 Mt Carmel Way in Pittsburg, Kansas, offers the CPT code 70553 for an MRI of the brain with and without contrast. The facility's cash median rate is $3,791.00, which is significantly higher than the state average cash rate of $351.00. While the gross billed amount for this service is $5,832.00, patients with commercial insurance may face negotiated rates that vary widely depending on their specific plan. For instance, Medicaid/KanCare plans have a median negotiated rate of $351.00, whereas some contracted commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $304.00 to $665.00. Conversely, several other contracted payers, including multiple Mercy Benefit Admin plans and Edison Health Solutions, have a fixed negotiated rate of $4,666.00, which exceeds the cash price.
For patients with high-deductible plans or those seeking to minimize out-of-pocket costs, paying the cash rate of $3,791.00 upfront might be more economical than relying on insurance, as some negotiated rates exceed the cash amount. It is important to note that prompt-pay discounts, which can reduce bills by 20% to 50% for upfront payment, are often available but must be requested before check-in to avoid automatic claims submission. Patients should also be aware that balance billing could occur if ancillary services are out-of-network, though the No Surprises Act provides protections against surprise bills for emergency care and non-emergency services at