MRI, brain (no contrast)
Facility: Rooks County Health Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $2,174
- Cash Discount Price: $1,812
- vs. Medicare Baseline: 8.92x 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 $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 892% of the Medicare baseline (a markup of 792%). 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 | $553 | 227% |
| Tricare | $1,135 | 466% |
| Celtic Mcr Adv | $1,135 | 466% |
| Veterans Admin - All Plans | $1,135 | 466% |
| Celtic Comm - All Other Plans | $1,249 | 512% |
| Preferred Benefits Admin | $2,174 | 892% |
| UnitedHealthcare | $2,174 | 892% |
| Aetna | $2,174 | 892% |
| Health Partners - All Plans | $2,295 | 941% |
| Preferred Hlthcare - All Other Plans | $2,295 | 941% |
| Healthy Blue Mcaid - All Plans | $2,416 | 991% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Rooks County Health Center in Plainville, KS, the facility's cash median rate of $1,812.00 is lower than the commercial negotiated rates paid by major insurers, which range from $1,135 to $2,416.00 depending on the specific plan. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that the facility offers a prompt-pay discount for patients who settle their bill in full within a short window, which can further reduce the final cost compared to the standard cash median.
When evaluating the financial impact of this service, it is helpful to compare the facility's pricing against the Medicare benchmark, which stands at $243.77 for this code. The commercial negotiated rates are significantly higher than the Medicare rate, reflecting the administrative costs and contract structures inherent in the insurance system. Although the data does not provide specific state or county average figures for comparison, the facility's cash rate of $1,812.00 represents a substantial portion of the gross charge of $2,416.00. Consumers are advised to request an itemized bill before payment to ensure no errors exist and to verify if any self-pay or prompt-pay discounts have been applied, as these can result in significant savings compared to the standard negotiated amounts.