MRI, brain (with and without contrast)
Facility: Kansas City Orthopaedic Institute
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,312
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.68x 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 368% of the Medicare baseline (a markup of 268%). 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 |
|---|---|---|
| Cigna | $336 - $1,016 | 94% |
| Aetna | $341 | 96% |
| UnitedHealthcare | $341 - $1,390 | 96% |
| Medica | $1,190 | 334% |
| Blue Cross Blue Shield | $1,300 - $1,324 | 365% |
Consumer Guidance & Cost Commentary
For this MRI of the brain at the Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates for in-network insurance plans range from $336 to $1,390, with a median negotiated amount of $1,312. These commercial rates are significantly higher than the Medicare benchmark of $356.43, reflecting the standard administrative overhead and contract dynamics that often inflate commercial pricing by 200% to 300% compared to federal rates. While the facility is a physician-owned acute care hospital, patients should be aware that the "in-network" status does not guarantee the lowest possible price, as different insurers have negotiated distinct ceilings that can vary widely even within the same region.
For patients with high-deductible plans, paying out-of-pocket cash or utilizing a prompt-pay discount may result in lower costs than using insurance, particularly since the cash median is not listed but the negotiated rates often exceed the true cost of care. It is crucial to verify your specific deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can lead to unexpected financial exposure. Additionally, patients should explicitly request a "self-pay" or "prompt-pay" discount prior to check-in and ensure they sign a waiver of insurance submission to avoid automatic claims processing that would void any cash savings. Given that over 80% of hospital bills contain errors, requesting a full itemized CPT-coded statement before finalizing payment is the most effective way to identify unbundled charges or services not rendered, ensuring you are only paying for what was actually provided.