MRI, brain (with and without contrast)
Facility: Saint John Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $372
- Cash Discount Price: $328
- vs. Medicare Baseline: 1.04x 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 |
|---|---|---|
| Medicaid / KanCare | $207 | 58% |
| Tricare | $329 | 92% |
| Medicare (plans) | $329 | 92% |
| Midland Care Connection | $329 | 92% |
| Cigna | $329 | 92% |
| UnitedHealthcare | $329 - $460 | 92% |
| Aetna | $329 - $607 | 92% |
| Kansas Superior Select | $335 | 94% |
| Healthy Blue | $345 - $376 | 97% |
| Celtic | $345 - $526 | 97% |
| Comp Alliance Workers Comp | $388 | 109% |
| Oha Networks | $419 | 118% |
| Worker Compensation | $431 | 121% |
| Employer Direct Healthcare | $460 | 129% |
| Corizon | $460 | 129% |
| Well Path | $460 | 129% |
| Centurion | $493 | 138% |
| Naphcare | $509 | 143% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Saint John Hospital in Leavenworth, KS, the cash median price is $328.00, which aligns closely with the state average of $328.00. While the facility's negotiated rates for commercial payers range from $207 to $607, the cash price remains the most predictable baseline for patients. It is important to note that for individuals with high-deductible plans, paying the cash price of $328.00 upfront can sometimes be more cost-effective than relying on insurance, as many commercial negotiated rates exceed this amount. Patients should verify their specific plan's deductible status before scheduling, as using insurance may result in higher out-of-pocket costs if the deductible has not yet been met. Additionally, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge. The Medicare allowed amount for this code is $356.43, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates often average between 200% and 300% of the Medicare rate, though fair pricing is typically defined as 120% to 150% of this benchmark. For instance, while some payers like Medicaid / KanCare and Tricare have negotiated rates as low as $207, others such as Celtic and Aetna have rates reaching up to $526 and $607 respectively.