MRI, brain (no contrast)
Facility: Stormont Vail Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $222
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.91x 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.
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 |
|---|---|---|
| Ambetter / Centene | $134 - $238 | 55% |
| UnitedHealthcare | $134 - $238 | 55% |
| Blue Cross Blue Shield | $135 - $705 | 55% |
| Aetna | $218 - $222 | 89% |
| Humana | $218 - $222 | 89% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $134 to $705 depending on the insurance carrier, with a median paid amount of $238. This negotiated rate is 90% of the Medicare benchmark of $243.77, indicating the facility is pricing at a level consistent with fair market value rather than applying a significant markup. While the gross charge listed is $2,862, the actual amounts paid by insurers are substantially lower, reflecting standard contract caps. It is important to note that while these negotiated rates protect in-network members, they often exceed the cash price; for patients with high-deductible plans, paying the cash price directly or utilizing a prompt-pay discount could result in lower out-of-pocket costs compared to the insurance allowed amount.
The facility offers a median negotiated rate of $222, which aligns closely with the lowest and highest negotiated ranges observed across payers like Ambetter/Centene and UnitedHealthcare. Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under federal law, though unexpected charges can still occur if ancillary services are out-of-network. To ensure you receive the most accurate pricing, always request an itemized bill before finalizing payment to verify that no unbundled codes or services not rendered have been included. Additionally, inquire directly with the hospital about self-pay or prompt-pay discounts, which can reduce the total bill by 20% to 50% if paid in full upfront, effectively bypassing the administrative costs associated with insurance claims processing.