MRI, brain (with and without contrast)
Facility: Rooks County Health Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $2,535
- Cash Discount Price: $2,300
- vs. Medicare Baseline: 7.11x 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 711% of the Medicare baseline (a markup of 611%). 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 | 155% |
| Veterans Admin - All Plans | $1,324 - $1,559 | 371% |
| Celtic Mcr Adv | $1,324 - $1,559 | 371% |
| Tricare | $1,324 - $1,559 | 371% |
| Celtic Comm - All Other Plans | $1,456 - $1,715 | 408% |
| UnitedHealthcare | $2,535 - $2,986 | 711% |
| Aetna | $2,535 - $2,986 | 711% |
| Preferred Benefits Admin | $2,535 - $2,986 | 711% |
| Health Partners - All Plans | $2,675 - $3,152 | 750% |
| Preferred Hlthcare - All Other Plans | $2,675 - $3,152 | 750% |
| Healthy Blue Mcaid - All Plans | $2,816 - $3,318 | 790% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Rooks County Health Center in Plainville, KS, the facility's cash median rate is $2,300, which is lower than the state average of $2,535. While many insurance plans negotiate rates starting at $2,535, patients with high-deductible plans might find paying cash upfront more cost-effective, as the cash price is already below the lowest negotiated amount. To secure the best possible rate, it is recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
Although the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific county average for comparison. However, the Medicare benchmark for this service is $356.43, which serves as a baseline for evaluating pricing fairness. Commercial negotiated rates for this procedure range from $1,324 to $3,318 depending on the payer, with UnitedHealthcare, Aetna, and Preferred Benefits Admin all settling at the $2,535 median. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, they should still request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.