MRI, brain (with and without contrast)
Facility: Pratt Regional Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $402
- Cash Discount Price: $1,618
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| Christian Health Aid | $302 - $3,166 | 85% |
| UnitedHealthcare | $334 - $4,305 | 94% |
| Health Partners Of Kansas | $342 - $3,588 | 96% |
| Celtic Insurance Company | $356 | 100% |
| Aetna | $362 - $3,799 | 102% |
| Healthy Blue | $367 | 103% |
| Choicecare | $402 - $4,221 | 113% |
Consumer Guidance & Cost Commentary
For this MRI of the brain at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price of $1,618 is significantly lower than the negotiated rates paid by major insurers like UnitedHealthcare and Aetna, which range from $334 to $4,305 depending on the plan. While the gross chargemaster lists at $2,312 may appear high, the cash price offers a substantial discount for self-pay patients. It is important to note that for individuals with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
The facility's pricing is evaluated against federal benchmarks, showing a markup of 1.1 times the Medicare rate of $356.43 for this procedure. While the data does not provide specific state or county average comparisons for this exact code, the significant gap between the cash price and the highest negotiated rates highlights the importance of understanding your plan's allowed amount versus the actual charge. To avoid unexpected costs, consumers should request a full itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors. If a balance bill arises from an out-of-network ancillary service, patients are protected under the No Surprises Act and should dispute the charge with their insurer rather than paying immediately.