CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Saint John Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $238
  • Cash Discount Price: $224
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Saint John Hospital is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 3500 South 4Th Street, Leavenworth, KS.
Cash / Self-Pay
$224

Average discount available for prompt cash payment at this facility.

Insurance Median
$238

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: $224 (92%)
Insurance Median: $238 (98%)
Cash: $224 (92% of Medicare)
Ins. Median: $238 (98% 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.

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
Medicaid / KanCare $131 54%
Cigna $225 92%
Tricare $225 92%
Aetna $225 - $362 92%
Medicare (plans) $225 92%
UnitedHealthcare $225 - $315 92%
Midland Care Connection $225 92%
Kansas Superior Select $229 94%
Comp Alliance Workers Comp $231 95%
Healthy Blue $236 - $238 97%
Celtic $236 - $360 97%
Oha Networks $249 102%
Worker Compensation $256 105%
Blue Cross Blue Shield $262 - $553 107%
Employer Direct Healthcare $315 129%
Well Path $315 129%
Corizon $315 129%
Centurion $337 138%
Naphcare $348 143%

Consumer Guidance & Cost Commentary

For the MRI, brain (no contrast) procedure at Saint John Hospital in Leavenworth, KS, the facility's cash median rate of $224.00 is significantly lower than the negotiated rates charged to most insurance plans, which range from $225 to $553 depending on the carrier. While the facility's gross charge is $5,586, commercial payers like Aetna and Blue Cross Blue Shield have negotiated rates that can exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that while the facility is a voluntary non-profit acute care hospital, the negotiated rates reflect the administrative costs and contract structures of insurance billing, which often inflate the baseline price compared to the direct cash price.

Patients should be aware that insurance companies negotiate maximum rates to protect their members, but these rates are not always the lowest possible option available. For instance, Medicaid/KanCare has a single plan with a rate of $131, which is lower than the cash median, though many other payers charge more. To ensure you are not overcharged, always verify your specific plan's allowed amount before scheduling and ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront. Additionally, if you receive a bill from an out-of-network provider at this in-network facility, the No Surprises Act may protect you from balance billing for emergency or non-emergency services, so you should dispute any unexpected charges rather than paying them immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 South 4Th Street, Leavenworth, KS 66048
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals