MRI, brain (no contrast)
Facility: Hamilton County Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $872
- Cash Discount Price: $969
- vs. Medicare Baseline: 3.58x 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 358% of the Medicare baseline (a markup of 258%). 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 | $247 - $553 | 101% |
| First Health Coventry - All Plans | $824 | 338% |
| Cigna | $921 | 378% |
| UnitedHealthcare | $921 | 378% |
| Va Ccn - All Plans | $969 | 398% |
| Aetna | $1,647 | 676% |
Consumer Guidance & Cost Commentary
For this MRI of the brain (no contrast) at Hamilton County Hospital in Syracuse, KS, the cash price is $969.00, which matches the facility's median negotiated rate and the Medicare benchmark of $243.77. While the facility is a Critical Access Hospital with government-local ownership, the cash price is significantly higher than the Medicare rate, reflecting the standard markup for commercial services. Patients should be aware that while insurance plans like Blue Cross Blue Shield and First Health Coventry have negotiated rates ranging from $247 to $921, these amounts often exceed the cash price. In cases where your deductible is high or you have a high-deductible plan, paying the cash price of $969.00 upfront may result in lower out-of-pocket costs compared to your insurance's allowed amount, especially if your plan does not cover the full negotiated rate.
To ensure you are not overcharged, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you choose to pay out-of-network or receive a balance bill, remember that the No Surprises Act protects you from being billed the difference between the provider's chargemaster and your insurance's allowed amount for emergency care and non-emergency services at in-network facilities. Additionally, you should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing. Always verify your specific plan's allowed amount and deductible status before scheduling to