MRI, brain (with and without contrast)
Facility: Providence Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $419
- Cash Discount Price: $328
- vs. Medicare Baseline: 1.18x 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 |
|---|---|---|
| Medicaid / KanCare | $207 | 58% |
| Aetna | $329 - $1,223 | 92% |
| Tricare | $329 | 92% |
| UnitedHealthcare | $329 - $789 | 92% |
| Cigna | $329 | 92% |
| Medicare (plans) | $329 | 92% |
| Midland Care Connection | $329 | 92% |
| Healthy Blue | $345 - $376 | 97% |
| Celtic | $345 - $526 | 97% |
| Kansas Superior Select | $345 | 97% |
| Comp Alliance - Fka Compresults Worker Compensation | $388 | 109% |
| Oha Networks | $419 | 118% |
| Corizon | $427 | 120% |
| Worker Compensation | $431 | 121% |
| Well Path Prison | $460 | 129% |
| Employer Direct Healthcare | $460 | 129% |
| Centurion | $493 | 138% |
| Naphcare | $509 | 143% |
| Blue Cross Blue Shield | $526 - $858 | 148% |
| First Health | $1,200 | 337% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Providence Medical Center in Kansas City, KS, the facility's cash median rate is $328.00, which is lower than the state average of $356.43. While commercial insurance plans typically negotiate rates ranging from $207 to $1,200 depending on the carrier, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially beneficial to pay the cash rate directly, as the $328.00 self-pay price is significantly lower than the average negotiated payment of $419.00 or the median paid amount of $1,363.00. To secure this lower rate, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as hospitals often offer fee reductions of 20% to 50% for upfront payment that bypass costly insurance billing cycles.
It is important to distinguish between the facility's gross charge of $6,155.00 and the actual rates patients will encounter, as the latter are governed by insurance contracts or cash agreements. The No Surprises Act provides federal protection against balance billing for emergency care and non-emergency services at in-network facilities, meaning patients should not fear unexpected bills for out-of-network ancillary services like emergency physicians or lab tests performed at this acute care hospital. If a patient receives a bill that appears to include charges beyond the negotiated or cash rate, they should request a formal itemized billing audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain