MRI, brain (with and without contrast)
Facility: Clara Barton Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,927
- Cash Discount Price: $1,506
- vs. Medicare Baseline: 5.41x 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 541% of the Medicare baseline (a markup of 441%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $521 | 146% |
| 6 Degrees Health - All Plans | $1,499 - $1,514 | 421% |
| Wppa-All Plans | $1,713 - $1,730 | 481% |
| UnitedHealthcare | $1,927 - $1,947 | 541% |
| Aetna | $1,927 - $1,947 | 541% |
| Phcs - All Plans | $1,927 - $1,947 | 541% |
| Hlth Partners Of Ks-All Plans | $1,970 - $1,990 | 553% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Clara Barton Hospital in Hoisington, KS, the cash median price is $1,506, which is lower than the facility's negotiated rate of $1,927. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance carriers like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $521 to $1,990 depending on the specific plan. It is important to note that while cash payments can sometimes be cheaper for those with high-deductible plans, the facility's cash rate is still significantly higher than the Medicare benchmark of $356.43 for this procedure. To ensure you are receiving the best possible price, we recommend asking the billing department about self-pay or prompt-pay discounts before scheduling your appointment, as these upfront payment incentives can further reduce the final cost.
When reviewing your final invoice, it is crucial to request a full itemized bill rather than accepting a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Additionally, your commercial rates should be evaluated against the Medicare benchmark to understand the true cost of care; in this case, the facility's negotiated rates are approximately 5.4 times the Medicare amount, highlighting the importance of verifying your in-network allowed amounts and checking your deductible status before