MRI, brain (no contrast)
Facility: Nemaha Valley Community Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $1,105
- Cash Discount Price: $1,981
- vs. Medicare Baseline: 4.53x 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 453% of the Medicare baseline (a markup of 353%). 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% |
| Humana | $969 | 398% |
| Va Ccn - All Plans | $969 | 398% |
| Aetna | $978 - $1,871 | 401% |
| Celtic Comm Exch - All Plans | $1,066 | 437% |
| Partners Direct Health - All Plans | $1,145 | 470% |
| Multiplan - All Plans | $1,981 | 813% |
| Midlands Choice - All Plans | $2,092 | 858% |
| Health Partners - All Plans | $2,092 | 858% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Nemaha Valley Community Hospital in Seneca, KS, the cash price of $1,981 is notably higher than the state average of $1,145. While commercial insurance plans like Aetna and Multiplan negotiate rates ranging from $969 to $2,092, these figures often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as it avoids the administrative costs and potential underpayment risks associated with insurance billing cycles. It is important to verify your specific plan's negotiated rate before scheduling, as some in-network contracts can result in higher out-of-pocket costs than self-pay options.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts from the hospital, which can reduce the bill by 20% to 50% for upfront payment. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership, they may offer additional financial assistance programs not reflected in standard billing data. If you choose to use insurance, be aware that the allowed amount of $1,105 represents the insurer's maximum payment, but you may still be responsible for the difference if your deductible has not been met. Always request a detailed, itemized bill before finalizing payment to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit.