MRI, brain (with and without contrast)
Facility: Centura St. Catherine-Dodge City
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,332
- Cash Discount Price: $810
- vs. Medicare Baseline: 3.74x 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 374% of the Medicare baseline (a markup of 274%). 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 |
|---|---|---|
| Kaiser | $189 | 53% |
| Humana | $189 | 53% |
| Aetna | $189 - $1,619 | 53% |
| Blue Cross Blue Shield | $189 - $650 | 53% |
| Cigna | $189 | 53% |
| Medicare (plans) | $189 | 53% |
| Kansas Health | $189 | 53% |
| Centura Employee Plan | $543 | 152% |
| UnitedHealthcare | $1,332 | 374% |
| Wpaa | $1,417 | 398% |
| Multiplan | $1,619 - $1,822 | 454% |
| Christian Health Aid | $1,619 | 454% |
| Health Partners Of Kansas | $1,822 | 511% |
Consumer Guidance & Cost Commentary
For the MRI of the brain at Centura St. Catherine-Dodge City in Dodge City, KS, the facility's cash median rate is $810, which is significantly lower than the state average of $1,332. While many commercial payers have negotiated rates ranging from $189 to $1,822, these amounts are often inflated by administrative costs and contract dynamics that can exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the $810 cash median is lower than the median negotiated rate of $1,332. To maximize savings, it is essential to verify "self-pay" or "prompt-pay" discounts with the hospital before scheduling, as these upfront payment incentives can bypass the higher administrative fees associated with insurance billing.
The facility's Medicare benchmarking rate of $356.43 serves as a critical baseline for evaluating pricing fairness, as commercial rates often average 200% to 300% of this figure. In this case, the gross charge of $2,024 represents a substantial markup compared to the Medicare amount, highlighting the importance of comparing rates against federal benchmarks rather than the hospital's full chargemaster list. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the allowed amount and the full charge, though federal protections like the No Surprises Act ban such practices for emergency and non-emergency services at in-network facilities. Consumers should always request a detailed, itemized bill to identify any errors, unbundled codes, or services not rendered, as over 8