MRI, brain (with and without contrast)
Facility: Grisell Memorial Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $785
- Cash Discount Price: $855
- vs. Medicare Baseline: 2.20x 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 220% of the Medicare baseline (a markup of 120%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $495 | 139% |
| UnitedHealthcare | $670 - $900 | 188% |
| Humana | $900 | 253% |
| Medicaid / KanCare | $900 | 253% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Grisell Memorial Hospital in Ransom, KS, the cash median price is $855.00, which is lower than the facility's negotiated rates of $785.00 and the Medicare benchmark of $356.43. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans might find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates paid by payers like UnitedHealthcare and Humana exceed the cash amount. It is important to note that while the facility offers a cash rate, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill by bypassing administrative claim processing fees.
Insurance coverage varies significantly by plan, with Blue Cross Blue Shield paying a fixed $495 and Medicaid/KanCare also at $900, while UnitedHealthcare plans range from $670 to $900. Because the facility is an in-network location for these payers, the No Surprises Act protects patients from balance billing for emergency care or non-emergency services from out-of-network providers at this hospital. However, patients should still request a full itemized CPT-coded bill to verify that no unbundled codes or services not rendered have inflated the total, as over 80% of hospital bills contain errors. Comparing these specific allowed amounts to the state average helps ensure that the commercial rates charged are fair relative to the regional cost baseline established by Medicare.