MRI, brain (with and without contrast)
Facility: Mcpherson Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $321
- Cash Discount Price: $1,964
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| UnitedHealthcare | $85 - $4,558 | 24% |
| Tricare | $88 - $282 | 25% |
| Humana | $101 - $321 | 28% |
| Blue Cross Blue Shield | $101 - $321 | 28% |
| Va Ccn - All Plans | $101 - $321 | 28% |
| Healthy Blue Mcr Adv | $101 - $321 | 28% |
| Wellcare Mcr Adv - All Plans | $101 - $321 | 28% |
| Ambetter / Centene | $101 - $369 | 28% |
| Aetna | $101 - $4,558 | 28% |
| Multiplan - All Plans | $125 - $4,102 | 35% |
| Medicaid / KanCare | $311 - $4,558 | 87% |
| Health Blue Mcaid - All Other Plans | $317 - $4,649 | 89% |
| Central Plains - All Plans | $562 - $3,418 | 158% |
| Medical Associates - All Plans | $562 - $3,418 | 158% |
| Cigna | $712 - $4,330 | 200% |
| Health Partners - All Plans | $712 - $4,330 | 200% |
| Wppa - All Plans | $3,191 | 895% |
| Christian Health Aid - All Plans | $3,646 | 1023% |
| First Health - All Plans | $4,330 | 1215% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at McPherson Hospital in Mcpherson, KS, the cash median price is $1,964, which is lower than the facility's gross charge of $2,654. While the hospital's negotiated rates with major payers like UnitedHealthcare and Aetna range significantly higher, reaching up to $4,558, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows a negotiated rate that exceeds the cash price. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details before scheduling. Additionally, patients should ask the hospital directly about self-pay or prompt-pay discounts, which can offer a fee reduction of 20% to 50% for upfront payment, bypassing the administrative costs associated with insurance claims processing.
The facility's Medicare benchmarking rate for this procedure is $356.43, which serves as a scientifically validated baseline for evaluating pricing markups. Commercial negotiated rates often average 200% to 300% of Medicare, though fair pricing is typically defined as 120% to 150% of this amount. To ensure accuracy and avoid unexpected costs, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If a balance bill is received, patients should dispute it in writing with the insurer and request a No Surprises Act