CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $550
  • Cash Discount Price: $2,341
  • vs. Medicare Baseline: 2.26x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Mercy Specialty Hospital Southeast Kansas is $550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,341. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.26x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$2,341

Average discount available for prompt cash payment at this facility.

Insurance Median
$550

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: $2,341 (960%)
Insurance Median: $550 (226%)
Cash: $2,341 (960% of Medicare)
Ins. Median: $550 (226% 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 226% of the Medicare baseline (a markup of 126%). 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
Humana $110 - $235 45%
Medicaid / KanCare $110 - $403 45%
Aetna $110 - $231 45%
Provider Partners Health Plans Contracted [320450] $117 48%
Blue Cross Blue Shield $131 - $564 54%
First Health Contracted [320128] $181 74%
UnitedHealthcare $206 - $3,332 85%
Medical Associates Health Contracted [320444] $231 95%
Mercy Hospice Okc [20252] $231 95%
Elara Caring Aspire Hospice [20433] $231 95%
Kindful Hospice Contracted [320434] $231 95%
Mercy Mgd Behavioral Health Contracted [320259] $231 95%
Cigna $231 - $935 95%
Cross Timbers Hospice [20098] $231 95%
Medicare (plans) $231 95%
Halo Hcr Inc Hospice Contracted [320432] $231 95%
Tricare $231 95%
Pace Of The Ozarks Contracted [320518] $231 95%
Globalhealth Contracted [320145] $231 95%
Cherokee Nation Health Serv Contracted [320066] $231 95%
Kindful Hospice [20434] $231 95%
Qual Choice Contracted [320325] $231 95%
Halo Hcr Inc Hospice [20432] $231 95%
Centivo Contracted [320505] $235 96%
Dept Of Veteran Affairs Contracted [320106] $235 96%
United Medical Resources Contracted [320454] $276 - $581 113%
Providrs Care Network Contracted [320484] $447 183%
Insurance System Inc Contracted [320465] $581 238%
Benefit Management Contracted [320052] $581 238%
Health Systems Inc Contracted [320174] $581 238%
Healthscope Contracted [320182] $581 - $2,702 238%
Point C Contracted [320238] $581 - $2,702 238%
Medica Contracted [320239] $1,101 452%
Mercy Benefit Admin Contracted [320251] $1,210 - $2,521 496%
Show-Me Health Administrators Contracted [320483] $1,210 496%
Yuzu Health Contracted [320521] $2,521 1034%
Reflect Health Contracted [320492] $2,521 1034%
American Healthcare Alliance Contracted [320020] $2,521 1034%
Ebms Contracted [320493] $2,521 1034%
Auxiant Contracted [320462] $2,521 - $2,702 1034%
Aither Health Contracted [320449] $2,521 1034%
Edison Health Solutions Contracted [320502] $2,521 1034%
Imagine 360 Contracted [320494] $2,521 1034%
Healthlink Contracted [320179] $2,702 1108%
Preferred Health Plan Contracted [320522] $2,702 1108%
Federal Medical Center Contracted [320127] $2,702 1108%
Compcare Of The Ozarks Contracted [320437] $2,846 1167%
Workers Comp [20426] $2,882 1182%
Private Health Care Systems Contracted [320320] $3,332 1367%
Multiplan [20270] $3,422 1404%
Multiplan Contracted [320270] $3,422 1404%

Consumer Guidance & Cost Commentary

For the MRI of the brain (no contrast) at Mercy Specialty Hospital Southeast Kansas, the facility's cash price of $2,341 is significantly higher than the state average for this service, which is $384. While commercial insurance plans like UnitedHealthcare and Cigna have negotiated rates that can reach up to $2,702, these amounts often exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans. Because insurance contracts include administrative overhead and multi-layered pricing structures, the negotiated rates do not always reflect the true cost of care; in this case, paying out-of-pocket directly can result in substantial savings compared to the maximum amounts billed by major payers.

To secure the best possible rate, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their appointment, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is also important to verify your specific plan's deductible status, as using insurance before meeting your deductible may result in paying the full negotiated amount rather than a reduced share. Finally, always request a detailed, itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected to lower your total debt.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals