MRI, brain (with and without contrast)
Facility: Stevens County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $955
- Cash Discount Price: $1,098
- vs. Medicare Baseline: 2.68x 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 $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 268% of the Medicare baseline (a markup of 168%). 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 |
|---|---|---|
| Humana | $406 | 114% |
| Aetna | $418 - $1,098 | 117% |
| Blue Cross Blue Shield | $525 - $553 | 147% |
| First Health - All Plans | $988 | 277% |
| Wppa - All Plans | $1,043 | 293% |
| Medicaid / KanCare | $1,098 | 308% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Stevens County Hospital in Hugoton, Kansas, the cash price is $1,098, which matches the facility's gross chargemaster rate. This cash rate is significantly higher than the state average for this service, which is $1,098.00, and notably higher than the county average of $1,098.00. While commercial insurance plans like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $406 to $1,098, patients with high-deductible plans might find the cash price more affordable if their insurance allowed amount exceeds the cash rate. It is important to note that the median negotiated rate across all payers is $955, which is lower than the cash price, suggesting that for those with active insurance coverage, the negotiated rate may result in lower out-of-pocket costs depending on their specific plan deductible status.
The facility, a Critical Access Hospital owned by the local government, has a Medicare benchmark of $356.43, which serves as the objective baseline for evaluating pricing markups. The cash price of $1,098 represents a markup of 2.7 times the Medicare amount, which is well above the typical fair pricing range of 120% to 150% of Medicare. Patients should be aware that balance billing could occur if they receive care from out-of-network providers, though the No Surprises Act protects against surprise bills for emergency services at in-network facilities. To minimize costs, patients are encouraged to request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 5