MRI, brain (no contrast)
Facility: Pratt Regional Medical Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $2,132
- Cash Discount Price: $1,794
- vs. Medicare Baseline: 8.75x 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 $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 875% of the Medicare baseline (a markup of 775%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Celtic Insurance Company | $227 | 93% |
| Healthy Blue | $234 | 96% |
| UnitedHealthcare | $250 - $2,614 | 103% |
| Christian Health Aid | $1,922 | 788% |
| Health Partners Of Kansas | $2,179 | 894% |
| Aetna | $2,307 | 946% |
| Choicecare | $2,563 | 1051% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Pratt Regional Medical Center in Pratt, KS, the facility's cash median rate of $1,794.00 is notably lower than the state average, which sits at $2,132.00. While commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $250 to $2,614 depending on the specific plan, these amounts often exceed the cash price. This pricing structure highlights a potential opportunity for patients with high-deductible plans: paying the cash median directly can result in immediate savings compared to the higher negotiated rates charged by insurance carriers. To maximize this benefit, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing is also contextualized by the Medicare benchmark, which stands at $243.77 for this service. The cash rate of $1,794.00 represents a significant markup over the federal baseline, a common characteristic of commercial healthcare pricing where administrative costs and risk premiums are factored in. However, the negotiated rates paid by major insurers generally align closer to the state average than the gross charges, suggesting that while the facility charges a premium over Medicare standards, its contracted rates with carriers like Celtic Insurance Company and Healthy Blue remain relatively consistent. Consumers are advised to verify their specific plan's allowed amount and check for any "prompt-pay" discounts available at registration, as these can bridge the gap between the high negotiated rates and the lower cash price.