MRI, brain (no contrast)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $224
- Cash Discount Price: $833
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| UnitedHealthcare | $58 - $626 | 24% |
| Aetna | $60 - $243 | 25% |
| Medicaid / KanCare | $60 - $310 | 25% |
| Providrs Care | $94 - $275 | 39% |
| Humana | $224 - $226 | 92% |
| Medicare (plans) | $224 - $228 | 92% |
| Va | $224 | 92% |
| Smarthealth | $313 | 128% |
| Tricare | $338 | 139% |
| Ambetter / Centene | $380 | 156% |
| Blue Cross Blue Shield | $598 - $630 | 245% |
Consumer Guidance & Cost Commentary
For this MRI of the brain (no contrast) at Ascension Via Christi Hospital Manhattan, Inc, the cash price is $833.00, which is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare (up to $626) and Aetna (up to $243). While the facility's cash rate is higher than the state average of $833.00, patients with high-deductible plans or those without insurance may find paying cash directly more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to deductibles and co-pays. It is important to note that while the facility offers a cash price, commercial insurance contracts often set a ceiling that prevents patients from paying the full cash amount if they use their plan, meaning the negotiated rate can sometimes exceed the cash price depending on the specific payer.
The facility's Medicare benchmark rate of $243.77 serves as a critical baseline for understanding pricing, as commercial negotiated rates frequently range from 200% to 300% of this amount, though fair pricing is typically defined as 120% to 150%. For this specific procedure, the median negotiated rate across payers is $224.00, which is lower than the Medicare amount, suggesting favorable contract terms for some insurers. However, patients should be aware of balance billing risks if they receive care from out-of-network providers, where the hospital could bill the difference between the full chargemaster and the insurance allowed amount, though the No Surprises Act protects against this for emergency and non-emergency services at in-network facilities. To minimize costs,