MRI, brain (with and without contrast)
Facility: Ellinwood District Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $525
- Cash Discount Price: $638
- vs. Medicare Baseline: 1.47x 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 |
|---|---|---|
| Blue Cross Blue Shield | $525 | 147% |
| Cigna | $525 | 147% |
| Aetna | $525 | 147% |
| UnitedHealthcare | $525 | 147% |
| Humana | $525 | 147% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Ellinwood District Hospital in Ellinwood, KS, the facility's cash median rate of $638.00 is notably higher than the negotiated rates of $525.00 accepted by major insurers like Blue Cross Blue Shield, Cigna, Aetna, UnitedHealthcare, and Humana. While the cash price may appear higher, it is important to note that for patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than relying on insurance, as the insurer's negotiated rate of $525.00 often exceeds the cash price. However, patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed before any insurance claim is processed.
This service is benchmarked against the federal Medicare rate of $356.43, showing a markup factor of 1.5 times the Medicare amount. The facility, a Critical Access Hospital owned by a Government Hospital District, has a consistent allowed amount of $525.00 across all five payer plans listed, with no variation in the low or high price points. Because the data provided does not include specific county or state average figures for comparison, the focus remains on the relationship between the facility's negotiated rates, the cash price, and the established Medicare baseline to help patients understand the true cost structure of this service.