CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Saint Luke'S South Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,782
  • Cash Discount Price: $3,152
  • vs. Medicare Baseline: 7.31x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Saint Luke'S South Hospital is $1,782. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,152. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.31x the Medicare baseline. Located in 12300 Metcalf Avenue, Overland Park, KS.
Cash / Self-Pay
$3,152

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,782

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $3,152 (1293%)
Insurance Median: $1,782 (731%)
Cash: $3,152 (1293% of Medicare)
Ins. Median: $1,782 (731% of 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 731% of the Medicare baseline (a markup of 631%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $131 - $309 54%
Humana $138 - $226 57%
Aetna $198 - $4,991 81%
UnitedHealthcare $242 - $1,782 99%
Cigna $263 - $3,988 108%
Transplants-Case Rates [5750] $275 - $5,254 113%
Blue Cross Blue Shield $533 - $3,946 219%
Commercial-Contracted [8000] $1,439 - $4,250 590%
First Health [5512] $3,115 1278%

Consumer Guidance & Cost Commentary

For the MRI, brain (no contrast) procedure at Saint Luke's South Hospital in Overland Park, KS, the facility's cash median price of $3,152 is significantly higher than the state average of $829. While commercial insurance plans like Aetna and Cigna have negotiated rates ranging from $198 to nearly $4,000, patients with high-deductible plans should consider that paying cash upfront might be more cost-effective if the insurance allowed amount exceeds the cash price. It is crucial to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the total cost by bypassing administrative claim processing costs.

The facility's negotiated rates vary widely across payers, with the lowest commercial rate found at $131 for Medicaid/KanCare and the highest at $5,254 for Transplants-Case Rates. When comparing these figures to the Medicare benchmark of $243.77, the commercial negotiated rates often reflect a markup that exceeds typical fair pricing standards. Patients should avoid accepting summary bills without requesting a full itemized audit to identify any unbundled codes or services not rendered, and they should verify their deductible status before relying on insurance to ensure they are not paying the full negotiated amount out of pocket.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12300 Metcalf Avenue, Overland Park, KS 66213
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals