MRI, brain (no contrast)
Facility: Graham County Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $601
- Cash Discount Price: $775
- vs. Medicare Baseline: 2.47x 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 247% of the Medicare baseline (a markup of 147%). 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 |
|---|---|---|
| Medicaid / KanCare | $374 | 153% |
| UnitedHealthcare | $374 - $736 | 153% |
| Blue Cross Blue Shield | $521 | 214% |
| Medicare (plans) | $581 | 238% |
| Celtic Commercial-All Other Plans | $639 | 262% |
| Wppa (Providers Care)-All Plans | $736 | 302% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Graham County Hospital in Hill City, KS, the cash price is $775.00, which matches the facility's median paid amount. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly by payer, ranging from $374 for Medicaid / KanCare to $736 for UnitedHealthcare. It is important to note that cash payments can sometimes be more cost-effective than using insurance, particularly for patients with high-deductible plans where the insurance negotiated rate might exceed the cash price. Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the total cost by bypassing administrative billing cycles.
When comparing pricing, the Medicare amount for this service is $243.77, which serves as a key benchmark for evaluating the facility's markup. The cash price of $775.00 represents a 2.5x multiplier relative to the Medicare rate, indicating the standard commercial pricing structure used in this region. Since the data does not provide specific state or county average rates for comparison, patients should focus on the relationship between the Medicare baseline and their specific insurance allowed amounts. To ensure transparency, consumers are encouraged to request an itemized bill to review exact CPT codes and avoid summary bills that may obscure individual charges. If a patient receives a balance bill for out-of-network services, they may be eligible to dispute the amount under the No Surprises Act, which protects against unexpected charges for emergency and non-emergency care at in-network facilities.