MRI, brain (with and without contrast)
Facility: Lane County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $875
- Cash Discount Price: $875
- vs. Medicare Baseline: 2.45x 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 245% of the Medicare baseline (a markup of 145%). 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 |
|---|---|---|
| UnitedHealthcare | $788 - $875 | 221% |
| Aetna | $788 - $831 | 221% |
| Healthy Blue Mcr Adv - All Other Plans | $875 | 245% |
| Healthy Blue Mcaid | $875 | 245% |
| Medicaid / KanCare | $875 - $962 | 245% |
| Wppa Providers-All Plans | $1,312 | 368% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Lane County Hospital in Dighton, Kansas, the cash and negotiated rates are identical at $875.00, which matches the facility's median paid amount. This price is significantly higher than the Medicare benchmark of $356.43, indicating a markup of 2.5 times the federal rate. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide specific comparisons to state or county average rates for this procedure. Patients with high-deductible plans may find that paying the cash price of $875.00 upfront is more cost-effective than using insurance, as the negotiated rate often exceeds the cash price due to administrative overhead and contract dynamics.
To ensure you are receiving the most favorable rate, it is important to verify your specific insurance status before scheduling. Although UnitedHealthcare, Aetna, and Medicaid/KanCare have negotiated rates ranging from $788 to $962, these amounts vary by plan and may not reflect the lowest possible cost for your situation. If you are self-pay, you should explicitly ask the hospital about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if settled within 30 days. Additionally, if you receive a bill from an out-of-network provider at this in-network facility, the No Surprises Act protects you from balance billing for emergency care and non-emergency services, so you should dispute any unexpected charges rather than paying them immediately. Always request a full itemized bill to review every line item and ensure no unbundled codes or services not rendered have inflated your total.