MRI, brain (with and without contrast)
Facility: Kansas Medical Center Llc
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $321
- Cash Discount Price: $1,356
- vs. Medicare Baseline: 0.90x 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% |
| Indian Health | $289 | 81% |
| Tricare | $289 | 81% |
| Ambetter / Centene | $321 | 90% |
| Humana | $321 | 90% |
| Medadv_Wellcare | $321 | 90% |
| Blue Cross Blue Shield | $321 - $503 | 90% |
| Three_Rivers | $643 | 180% |
| United | $850 | 238% |
| Aetna | $900 | 253% |
| Wppa | $904 | 254% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Kansas Medical Center Llc in Andover, KS, the facility's cash median rate of $1,356 is significantly lower than the negotiated rates charged to most major payers, which range from $289 to $904 depending on the specific insurance plan. While the gross chargemaster lists at this Acute Care Hospital can reach $2,260, patients with high-deductible plans or those without insurance may find the cash price more affordable than the amount their insurer allows, which often exceeds the cash rate due to administrative overhead and contract dynamics. It is important to note that while the facility offers a cash median of $1,356, the actual self-pay or prompt-pay discount available could be lower if requested directly from the billing department prior to scheduling, as these incentives are not automatically applied to insurance claims.
The pricing for this service is benchmarked against federal standards, where the Medicare amount of $356.43 serves as the objective baseline for evaluating the facility's markup. Commercial negotiated rates for this CPT code generally average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of the Medicare amount. Although the data provided does not include specific Kansas or county average comparisons for this procedure, the significant gap between the Medicare benchmark and the facility's cash rate highlights the potential for substantial savings when paying out-of-pocket or utilizing prompt-pay discounts. Consumers are advised to request an itemized bill to verify all charges and to dispute any balance billing that may arise from out-of-network ancillary services,