MRI, brain (with and without contrast)
Facility: Lmh
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $351
- Cash Discount Price: $1,385
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Cigna | $131 - $3,700 | 37% |
| UnitedHealthcare | $131 - $3,678 | 37% |
| Medicare (plans) | $131 - $351 | 37% |
| Humana | $131 - $351 | 37% |
| Blue Cross Blue Shield | $153 - $3,584 | 43% |
| Haskell Indian Health Services | $153 - $351 | 43% |
| Allwell | $156 - $358 | 44% |
| Ambetter / Centene | $156 - $545 | 44% |
| Aetna | $1,721 - $4,597 | 483% |
| Non Contracted | $4,431 | 1243% |
| First Health | $5,151 | 1445% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Lmh in Lawrence, KS, the cash median price is $1,385.00, which is significantly lower than the facility's gross charge of $5,539.00. While the facility is government-owned and located in Lawrence (ZIP 66044), the data does not provide specific county or state average figures for this procedure, so a direct comparison to regional averages cannot be made. However, patients with high-deductible plans may find the cash price advantageous if their insurance negotiated rates exceed this amount. For instance, while several in-network payers like Cigna, UnitedHealthcare, and Blue Cross Blue Shield have negotiated ranges extending up to $3,700, the cash rate offers a lower baseline. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the final cost compared to a direct cash payment.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like emergency physicians or lab tests are billed separately. If you receive a bill that appears to include balance billing, you should dispute it with your insurer and request a No Surprises Act audit rather than paying immediately. Additionally, since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill before negotiating or paying to identify any unbundled codes or services not rendered. Finally, if you choose to pay out-of-pocket, ask the hospital about "self-pay" or "prompt-pay" discounts, which