MRI, brain (with and without contrast)
Facility: F W Huston Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $2,265
- Cash Discount Price: $2,353
- vs. Medicare Baseline: 6.35x 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 635% of the Medicare baseline (a markup of 535%). 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 | $526 | 148% |
| Aetna | $2,206 | 619% |
| Humana | $2,323 | 652% |
| Cigna | $2,500 | 701% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at F W Huston Medical Center in Winchester, KS, the facility's cash price of $2,353 is lower than the median negotiated rate of $2,265, suggesting that paying out-of-pocket might be more cost-effective for patients with high-deductible plans. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the specific county or state average for this procedure is not provided in the available data, so a direct regional comparison cannot be made. However, it is important to note that the facility's cash rate is significantly higher than the Medicare benchmark of $356.43, which serves as the federal baseline for evaluating pricing markups. Commercial insurance contracts often result in higher costs due to administrative overhead and contract dynamics, meaning that for some patients, the cash price could represent a substantial saving compared to what their insurer would allow.
Patients should verify their specific insurance status and deductible requirements before scheduling, as the median paid amount of $2,323 reflects the typical reimbursement received by the facility, not necessarily what an individual patient will owe. If you are self-paying, you may be eligible for additional "prompt-pay" discounts by requesting a self-pay classification and signing a waiver to prevent automatic claims submission to insurance companies. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, you can avoid unexpected charges even if certain ancillary services like lab work are billed separately. We recommend requesting a full, itemized bill before finalizing payment to ensure all charges are accurate and to identify any potential errors that could be disputed.