MRI, brain (no contrast)
Facility: Nmc Health
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $1,394
- Cash Discount Price: $1,697
- vs. Medicare Baseline: 5.72x 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 572% of the Medicare baseline (a markup of 472%). 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 |
|---|---|---|
| Bluestem Pace | $225 | 92% |
| Leading Age | $361 | 148% |
| Medicaid / KanCare | $361 | 148% |
| Blue Cross Blue Shield | $553 | 227% |
| Aetna | $900 | 369% |
| Wppa | $1,333 | 547% |
| Occunet | $1,454 | 596% |
| Medincrease Health Plan | $1,576 | 647% |
| Samaritan Ministries International | $1,576 | 647% |
| Prime Health Services | $1,818 | 746% |
| UnitedHealthcare | $2,182 | 895% |
| Cigna | $2,303 | 945% |
Consumer Guidance & Cost Commentary
For patients at Nmc Health in Newton, Kansas, the cost of an MRI of the brain without contrast varies significantly depending on payment method. While the facility's cash median price is $1,697, commercial insurance negotiated rates range from $225 for Bluestem Pace up to $2,303 for Cigna, with a median negotiated amount of $1,394. It is important to note that cash payments can sometimes be more cost-effective for individuals with high-deductible plans, as the cash price is often lower than the amount an insurer would allow. To secure the lowest possible rate, patients should verify their specific plan's allowed amount and inquire directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
When evaluating this cost against broader benchmarks, the Medicare amount for this procedure is set at $243.77, which serves as a scientifically validated baseline for healthcare delivery costs. Commercial negotiated rates typically average between 200% and 300% of this Medicare rate, whereas fair pricing is generally defined as 120% to 150%. In this case, the facility's cash median of $1,697 is approximately 5.7 times the Medicare amount. Patients should avoid comparing these figures to the hospital's gross charge list, as those inflated prices do not reflect the true cost of care. Instead, consumers are encouraged to request a detailed, itemized bill to ensure no errors exist and to confirm that the final charges align with their insurance allowed amount or the negotiated cash rate.