CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Medicine Lodge Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $691
  • Cash Discount Price: $727
  • vs. Medicare Baseline: 1.94x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Medicine Lodge Memorial Hospital is $691. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.94x the Medicare baseline. Located in 710 N Walnut Street, Medicine Lodge, KS.
Cash / Self-Pay
$727

Average discount available for prompt cash payment at this facility.

Insurance Median
$691

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $727 (204%)
Insurance Median: $691 (194%)
Cash: $727 (204% of Medicare)
Ins. Median: $691 (194% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

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 $583 164%
Humana $662 186%
Aetna $673 - $727 189%
Hpk-All Plans $691 194%
UnitedHealthcare $691 194%
Medicaid / KanCare $727 204%

Consumer Guidance & Cost Commentary

For the MRI of the brain (with and without contrast) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $727.00, which matches the facility's gross chargemaster rate. While this cash rate is significantly higher than the state average for this procedure, it is important to note that commercial insurance plans often pay negotiated rates that exceed the cash price. For example, Aetna's negotiated range spans from $673 to $727, and Medicaid/KanCare pays the full $727.00. Consequently, patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find paying the $727.00 cash price directly to the hospital to be the most cost-effective option, as it avoids the administrative overhead and potential higher negotiated fees associated with insurance billing.

To ensure you are receiving the best possible rate, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you are using insurance, be aware that the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, meaning you should not sign away your rights to dispute out-of-network charges for ancillary services like emergency physicians or lab work. If you receive a bill, always request a full itemized audit before paying, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered, and formal written disputes are far more effective than verbal negotiations.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 710 N Walnut Street, Medicine Lodge, KS 67104
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals