MRI, brain (no contrast)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $691
- Cash Discount Price: $727
- vs. Medicare Baseline: 2.83x 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 283% of the Medicare baseline (a markup of 183%). 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 | $583 | 239% |
| Humana | $662 | 272% |
| Aetna | $673 - $727 | 276% |
| UnitedHealthcare | $691 | 283% |
| Hpk-All Plans | $691 | 283% |
| Medicaid / KanCare | $727 | 298% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (no contrast) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $727.00, which matches the facility's gross charge and the highest negotiated rate among payers. While the median negotiated rate across six payers is $691.00, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance allows a rate higher than the cash price. It is important to note that the facility is a Critical Access Hospital owned by a Government Hospital District, and while the cash rate is the same as the gross charge, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to potentially reduce the final amount owed.
The Medicare benchmark for this procedure is $243.77, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific state or county average comparisons for this code, the facility's cash rate of $727.00 represents a significant markup over the Medicare amount. To ensure accuracy, patients should request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, so they should verify their network status and dispute any unexpected bills immediately rather than paying them out of fear of credit damage.