MRI, brain (no contrast)
Facility: Ellsworth County Medical Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $866
- Cash Discount Price: $962
- vs. Medicare Baseline: 3.55x 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 355% of the Medicare baseline (a markup of 255%). 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 |
|---|---|---|
| Triwest -All Plans | $452 | 185% |
| Humana | $452 - $914 | 185% |
| Healthy Blue Mcr Adv | $452 | 185% |
| Va Ccn-All Plans | $452 | 185% |
| Blue Cross Blue Shield | $495 - $521 | 203% |
| UnitedHealthcare | $625 - $962 | 256% |
| Aetna | $866 | 355% |
| First Health - All Plans | $866 | 355% |
| Cigna | $914 | 375% |
| Medicaid / KanCare | $962 | 395% |
| Coventry Mcaid-All Plans | $962 | 395% |
| Healthy Blue Mcaid- All Other Plans | $962 | 395% |
| Providers Care-Wppa-All Plans | $1,443 | 592% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Ellsworth County Medical Center in Ellsworth, KS, the facility's cash price of $962.00 aligns exactly with the cash median and the gross charge listed in this report. While the facility is a Critical Access Hospital with a Proprietary ownership structure, the negotiated rates vary significantly by payer, ranging from a low of $452 for Triwest and Healthy Blue Mcr Adv to a high of $962 for Medicaid and Coventry Mcaid-All Plans. It is important to note that for patients with high-deductible plans, paying the cash price of $962.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for many commercial payers, such as UnitedHealthcare and Aetna, can exceed the cash amount due to administrative overhead and contract dynamics.
When evaluating the cost relative to federal standards, the facility's cash price is 3.6 times the Medicare benchmark of $243.77, which serves as the objective baseline for evaluating hospital pricing markups. Although the report does not provide specific county or state average data for comparison, the wide variation in negotiated rates across the 13 payers listed highlights the importance of verifying allowed amounts before scheduling. To minimize costs, patients should proactively request self-pay or prompt-pay discounts prior to check-in, as these upfront payment incentives can bypass costly claims processing and reduce the final bill. Additionally, patients should avoid accepting summary bills and instead demand a full itemized statement to ensure no errors or unbundled charges are included in the final invoice.