MRI, brain (with and without contrast)
Facility: Kiowa District Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $903
- Cash Discount Price: $760
- vs. Medicare Baseline: 2.53x 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 253% of the Medicare baseline (a markup of 153%). 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 | 104% |
| Blue Cross Blue Shield | $521 | 146% |
| UnitedHealthcare | $760 - $950 | 213% |
| Health Partners Of Ks-All Plans | $836 | 235% |
| Humana | $857 | 240% |
| Multiplan-All Plans | $893 | 251% |
| Gbs Insurance - All Plans | $893 | 251% |
| Medicare (plans) | $902 | 253% |
| Triwest-All Plans | $902 | 253% |
| Aetna | $902 | 253% |
| Medicaid / KanCare | $950 | 267% |
| Healthchoice-All Plans | $955 | 268% |
| Providers Care (Wppa)-All Plans | $1,425 | 400% |
| Liberty Healthshare-All Plans | $1,534 | 430% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Kiowa District Hospital in Kiowa, KS, the cash median price is $760, while the median negotiated rate across payers is $893. This facility, a Critical Access Hospital owned by a government hospital district, has a gross charge of $950. Patients with high-deductible plans or those paying out-of-pocket may find the cash price of $760 more affordable than the insurance negotiated rate of $893, as commercial contracts often include administrative overhead that inflates the final bill. It is important to note that while the facility offers a cash median of $760, the median negotiated amount of $893 reflects the average payment from insurance carriers, meaning self-pay patients could potentially save money by paying directly and verifying any available prompt-pay discounts before scheduling.
When evaluating costs, it is crucial to compare these rates against the Medicare benchmark rather than the hospital's gross charge. The Medicare amount for this procedure is $356.43, which serves as the objective baseline for fair pricing; commercial negotiated rates typically range from 200% to 300% of this amount, whereas fair pricing is generally defined as 120% to 150%. In this case, the cash median of $760 represents approximately 213% of the Medicare rate, while the median negotiated rate of $893 is roughly 250%. To ensure accuracy, patients should request an itemized billing audit to review specific CPT codes and avoid paying for unbundled services or items not rendered, as summary bills often obscure these details. Additionally, since the