CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Graham County Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $605
  • Cash Discount Price: $775
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Graham County Hospital is $605. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $775. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.70x the Medicare baseline. Located in 304 West Prout Street, Hill City, KS.
Cash / Self-Pay
$775

Average discount available for prompt cash payment at this facility.

Insurance Median
$605

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $775 (217%)
Insurance Median: $605 (170%)
Cash: $775 (217% of Medicare)
Ins. Median: $605 (170% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

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 $521 146%
Medicare (plans) $581 163%
UnitedHealthcare $590 - $736 166%
Medicaid / KanCare $590 166%
Celtic Commercial-All Other Plans $639 179%
Wppa (Providers Care)-All Plans $736 206%

Consumer Guidance & Cost Commentary

For the MRI of the brain (with and without contrast) at Graham County Hospital in Hill City, Kansas, the cash price is $775.00, which matches the facility's median negotiated rate. This service is significantly more expensive than the state average, as indicated by a ratio of 1.7 times the Medicare benchmark of $356.43. While commercial payers like UnitedHealthcare and Wppa (Providers Care) have negotiated rates ranging from $590 to $736, these amounts remain higher than the cash price. Patients with high-deductible plans may find it financially advantageous to pay the $775.00 cash price directly, as this avoids the administrative overhead and markup often embedded in commercial negotiated rates.

Before scheduling, patients should verify their specific plan's allowed amount and check for "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50%. Although the facility is a Critical Access Hospital owned by the local government, the lack of a facility rating suggests further review of their pricing transparency. To ensure you are not overcharged, request a full itemized bill that breaks down every CPT code and unit cost, as summary bills often hide unbundled charges or services not rendered. Given that over 80% of hospital bills contain errors, it is essential to dispute any discrepancies in writing before making a payment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 304 West Prout Street, Hill City, KS 67642
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals