MRI, brain (with and without contrast)
Facility: Saint Luke'S South Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,782
- Cash Discount Price: $3,814
- vs. Medicare Baseline: 5.00x 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 500% of the Medicare baseline (a markup of 400%). 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 |
|---|---|---|
| Medicaid / KanCare | $207 - $457 | 58% |
| Humana | $229 - $376 | 64% |
| Aetna | $332 - $6,039 | 93% |
| UnitedHealthcare | $387 - $1,782 | 109% |
| Cigna | $413 - $4,825 | 116% |
| Transplants-Case Rates [5750] | $462 - $6,357 | 130% |
| Blue Cross Blue Shield | $701 - $4,774 | 197% |
| Commercial-Contracted [8000] | $1,439 - $5,143 | 404% |
| First Health [5512] | $3,768 | 1057% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Saint Luke's South Hospital in Overland Park, Kansas, the cash median price is $3,814, which is significantly lower than the facility's gross charge of $6,357. While commercial insurance plans like Aetna and Cigna have negotiated rates ranging from $332 to over $6,000, patients with high-deductible plans may find paying cash directly more cost-effective. The facility offers a prompt-pay discount for upfront payment, which can reduce the final bill, and it is recommended to explicitly request self-pay or prompt-pay rates before scheduling to avoid being billed the full negotiated amount by an insurance carrier.
When evaluating the cost, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare allowed amount for this service is $356.43, and the facility's negotiated rate of $1,782 represents a substantial markup above this federal baseline. Although the facility has a strong consumer rating of 4 stars, patients should be aware that balance billing can still occur if out-of-network ancillary services are involved, even at an in-network hospital. To protect against unexpected costs, consumers should demand a full itemized bill before paying and dispute any errors in writing, as over 80% of hospital bills contain mistakes that can be corrected through a formal audit.