MRI, brain (with and without contrast)
Facility: Stafford County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $995
- Cash Discount Price: $995
- vs. Medicare Baseline: 2.79x 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 279% of the Medicare baseline (a markup of 179%). 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 |
|---|---|---|
| Health Partners-All Plans | $945 | 265% |
| Humana | $995 | 279% |
| Va Ccn-All Plans | $995 | 279% |
| Medica Mcr- All Plans | $995 | 279% |
| UnitedHealthcare | $995 | 279% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Stafford County Hospital, the cash and negotiated rates are identical at $995.00, which matches the facility's gross charge. This rate is significantly higher than the state of Kansas average, which is approximately 2.8 times the Medicare benchmark of $356.43. While commercial insurance plans like Health Partners, Humana, and UnitedHealthcare all negotiate this same $995.00 rate, patients with high-deductible plans should consider that paying cash upfront might be more cost-effective if their insurance allowed amount exceeds this price. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the final bill.
Because the cash price equals the negotiated rate, there is no potential for balance billing from in-network insurers, but patients should remain vigilant regarding itemized billing audits. Over 80% of hospital bills contain errors, such as unbundled codes or charges for services not rendered, so patients should request a detailed line-by-line statement rather than accepting a summary bill. If any discrepancies appear, a formal written dispute sent to the billing supervisor is the most effective way to resolve errors. Additionally, since this facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan details to ensure they are aware of any out-of-network ancillary services that might trigger unexpected charges, though the No Surprises Act generally protects against balance billing for emergency and non-emergency care at in-network facilities.