MRI, brain (no contrast)
Facility: Holton Community Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $1,717
- Cash Discount Price: $1,552
- vs. Medicare Baseline: 7.04x 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 704% of the Medicare baseline (a markup of 604%). 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 | $521 | 214% |
| Aetna | $1,097 - $2,069 | 450% |
| UnitedHealthcare | $1,097 - $2,069 | 450% |
| Humana | $1,108 | 455% |
| Kansas Superior Select - All Plans | $1,118 | 459% |
| Preferred Health Freedom | $1,717 | 704% |
| Preferred Health Professionals | $1,717 | 704% |
| Preferred Health Fn Select - All Other Plans | $1,717 | 704% |
| Wppa Providers - All Plans | $1,966 | 806% |
| Medicaid / KanCare | $2,069 | 849% |
Consumer Guidance & Cost Commentary
For this MRI of the brain (no contrast) at Holton Community Hospital, the negotiated rates range from $521 to $2,069 depending on your specific insurance plan, with the lowest negotiated amount being $521 from Blue Cross Blue Shield and the highest at $2,069 from Medicaid/KanCare. The facility's cash price of $1,552 is notably higher than the state average of $1,108, which means patients with high-deductible plans might save money by paying cash directly rather than using insurance, as the insurer's allowed amount often exceeds the cash rate. However, since this is a Critical Access Hospital in Kansas, you should verify your specific plan's allowed amount before scheduling, as some in-network rates can be significantly higher than the cash price due to administrative costs and contract dynamics.
To ensure you are not overcharged, it is crucial to request an itemized bill that lists every specific CPT code and unit cost, as summary bills often hide unbundled charges or services not rendered. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, remember that the No Surprises Act generally protects you from these unexpected costs for emergency care and non-emergency services at in-network facilities. Finally, ask the hospital about prompt-pay discounts, which can reduce your total bill by 20% to 50% if you pay in full upfront, effectively bypassing the costly insurance claims processing cycle.