MRI, brain (no contrast)
Facility: Kiowa District Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $898
- Cash Discount Price: $760
- vs. Medicare Baseline: 3.68x 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 368% of the Medicare baseline (a markup of 268%). 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 |
|---|---|---|
| Tricare | $370 | 152% |
| Blue Cross Blue Shield | $521 | 214% |
| Healthchoice-All Plans | $583 | 239% |
| UnitedHealthcare | $760 - $950 | 312% |
| Health Partners Of Ks-All Plans | $836 | 343% |
| Humana | $857 | 352% |
| Multiplan-All Plans | $893 | 366% |
| Gbs Insurance - All Plans | $893 | 366% |
| Medicare (plans) | $902 | 370% |
| Aetna | $902 | 370% |
| Triwest-All Plans | $902 | 370% |
| Medicaid / KanCare | $950 | 390% |
| Providers Care (Wppa)-All Plans | $1,425 | 585% |
| Liberty Healthshare-All Plans | $1,534 | 629% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (no contrast) at Kiowa District Hospital in Kiowa, KS, the cash median price is $760.00, which is lower than the negotiated rates paid by most major insurers. While the facility's cash rate is competitive, many commercial payers, including UnitedHealthcare, Humana, and Aetna, have negotiated rates ranging from $857 to $950. This price transparency report highlights that for patients with high-deductible plans, paying the cash price of $760.00 upfront may result in significant savings compared to the insurance allowed amount, which often exceeds the cash rate. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.
It is important to understand that commercial insurance rates are often higher than cash prices due to administrative costs and contract structures, not because the service is more expensive. The Medicare benchmark for this procedure is $243.77, which serves as a reliable baseline for evaluating the facility's pricing; commercial rates are typically 200% to 300% of this amount, whereas fair pricing is generally defined as 120% to 150%. If you receive a bill from an out-of-network provider at this in-network facility, the No Surprises Act protects you from balance billing for emergency care and non-emergency services. Always request a full itemized CPT-coded bill before paying, as summary bills may hide unbundled charges or services not rendered, ensuring you are only paying for the actual care provided.