MRI, brain (with and without contrast)
Facility: Great Plains Of Sabetha
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,387
- Cash Discount Price: $1,460
- vs. Medicare Baseline: 3.89x 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 389% of the Medicare baseline (a markup of 289%). 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 |
|---|---|---|
| Celtic Mcr Adv | $759 | 213% |
| Aetna | $767 - $1,475 | 215% |
| Celtic Comm Exchange-All Other Plans | $949 | 266% |
| Great West Healthcare-All Plans | $1,241 | 348% |
| UnitedHealthcare | $1,358 - $1,460 | 381% |
| Century/Wppa/Providers-All Plans | $1,387 | 389% |
| Humana | $1,387 | 389% |
| Cigna | $1,387 | 389% |
| Multiplan-Phcs-All Plans | $1,387 | 389% |
| Federated Mutual Ins-All Plans | $1,402 | 393% |
| Medicaid / KanCare | $1,460 | 410% |
| Blue Cross Blue Shield | $1,460 | 410% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Great Plains of Sabetha, the cash price is $1,460, which matches the facility's negotiated rate with Medicaid/KanCare and Blue Cross Blue Shield. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $767 to $1,460, the cash price remains the highest figure in this dataset. Patients with high-deductible plans should consider paying cash directly, as the $1,460 cash rate is significantly lower than the average commercial negotiated rate of $1,387 for this specific service, potentially saving money if their insurance allows the full amount. It is important to verify with the hospital whether a "self-pay" or "prompt-pay" discount is available, as paying upfront can sometimes bypass administrative fees and reduce the final bill.
The Medicare benchmark for this procedure is $356.43, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $1,460 represents a 3.9x multiplier compared to the Medicare rate, reflecting the standard administrative and operational costs associated with commercial billing. Since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement before paying to ensure no unbundled codes or services not rendered are included. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may protect the patient from paying the difference between the chargemaster and the insurance allowed amount, so disputing unexpected charges with the insurer is a critical first step.