MRI, brain (with and without contrast)
Facility: Hamilton County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,542
- Cash Discount Price: $1,714
- vs. Medicare Baseline: 4.33x 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 433% of the Medicare baseline (a markup of 333%). 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 | 69% |
| First Health Coventry - All Plans | $1,457 | 409% |
| Cigna | $1,628 | 457% |
| UnitedHealthcare | $1,628 | 457% |
| Va Ccn - All Plans | $1,714 | 481% |
| Aetna | $2,913 | 817% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Hamilton County Hospital in Syracuse, KS, the cash price is $1,714, which matches the facility's median negotiated rate and the Medicare benchmark of $356.43. While the hospital is a Critical Access Hospital with government local ownership, the cash price is significantly higher than the Medicare rate, reflecting standard commercial pricing structures where negotiated rates often range from 200% to 300% of Medicare. Patients should note that while the cash price is fixed, commercial payers like Blue Cross Blue Shield and Cigna have negotiated rates ranging from $247 to $2,913 depending on the specific plan, meaning some insured members may pay less than the cash price if their deductible is met, though others might face higher out-of-pocket costs if their plan has high deductibles or if the negotiated rate exceeds the cash amount.
To optimize costs, patients should verify their specific insurance allowed amount before scheduling, as in-network rates vary widely among the six payers listed for this service. If you are self-pay or have a high-deductible plan where the insurance allowed amount exceeds the cash price, paying directly can sometimes be cheaper. Additionally, you should ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead of insurance billing. Since over 80% of hospital bills contain errors, it is advisable to request a detailed, itemized bill to review every charge and ensure no services were unbundled or duplicated before finalizing payment.