MRI, brain (with and without contrast)
Facility: Wesley Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $3,289
- Cash Discount Price: $19,011
- vs. Medicare Baseline: 9.23x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 923% of the Medicare baseline (a markup of 823%). 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 |
|---|---|---|
| UnitedHealthcare | $207 | 58% |
| Medicaid / KanCare | $213 | 60% |
| Aetna | $215 - $6,787 | 60% |
| Amerigroup | $215 | 60% |
| First Health | $410 - $8,764 | 115% |
| Multiplan | $427 - $17,110 | 120% |
| Blue Cross Blue Shield | $553 | 155% |
| United | $828 - $8,555 | 232% |
| Health Partners Of Kansas | $3,289 - $9,506 | 923% |
| Wppa | $3,308 | 928% |
| Ambetter / Centene | $3,422 | 960% |
| Medical Associates Health Plan | $3,593 | 1008% |
| Preferred Health Choices | $3,593 | 1008% |
| Spirit Aerosystems | $6,084 | 1707% |
| Triwest Healthcare Alliance | $12,357 | 3467% |
| Usa Managed Care | $16,159 | 4534% |
Consumer Guidance & Cost Commentary
For the CPT code 70553, representing an MRI of the brain with and without contrast at Wesley Medical Center in Wichita, KS, the cash median price is $19,011. This cash rate is significantly higher than the state average, which is $356.43, and also exceeds the facility's own negotiated rate of $3,289. While commercial payers like Aetna and First Health have negotiated rates ranging from $215 to $8,764, the cash price remains the lowest fixed amount listed for this service. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their specific insurance allowed amounts, which can vary widely depending on the plan. It is important to note that while the facility offers a cash rate, patients should verify if their specific insurance plan has a lower allowed amount before scheduling, as paying the full cash price might not result in the lowest out-of-pocket cost if the insurer's negotiated rate is lower.
When reviewing the billing for this procedure, consumers should be aware of the difference between the facility's gross charge of $19,011 and the actual amounts paid by insurers, which range from $207 to $16,159 depending on the payer. The facility's rating of 4 out of 5 reflects its standing as an acute care hospital in a proprietary ownership structure. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing, where the provider bills the difference between the chargemaster rate and the insurance allowed amount. To avoid this, patients should request a formal itemized billing audit