MRI, brain (with and without contrast)
Facility: Greenwood County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,659
- Cash Discount Price: $1,570
- vs. Medicare Baseline: 4.65x 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 465% of the Medicare baseline (a markup of 365%). 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 | $495 - $521 | 139% |
| Triwest - All Plans | $701 | 197% |
| Choicecare Mcr Adv - All Plans | $824 | 231% |
| Tricare | $824 | 231% |
| UnitedHealthcare | $824 - $1,649 | 231% |
| Integrated Health Plan - All Plans | $1,472 | 413% |
| First Health Ccn Network | $1,669 | 468% |
| First Health - All Other Plans | $1,669 | 468% |
| Beech Street - All Plans | $1,669 | 468% |
| Preferred Hs (Coventry) - All Plans | $1,767 | 496% |
| Principal Health Care Inc - All Plans | $1,865 | 523% |
| Medicaid / KanCare | $1,963 | 551% |
| Amerigroup Mcaid-All Plans | $1,963 | 551% |
| Providrs Care/Wppa - All Plans | $2,944 | 826% |
Consumer Guidance & Cost Commentary
For this MRI of the brain at Greenwood County Hospital in Eureka, Kansas, the cash price is $1,570, which is lower than the state average of $1,649. While many insurance plans have negotiated rates ranging from $495 to $2,944, patients with high-deductible plans might find the cash price more affordable if their insurance allowed amount exceeds this figure. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the cash price, so verifying your specific plan's allowed amount before scheduling is essential. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost if paid in full upfront.
The facility's Medicare benchmark rate is $356.43, which serves as a scientifically validated baseline for evaluating pricing markups. Commercial rates for this service are substantially higher than the Medicare amount, reflecting the multi-layered administrative structures and contract dynamics inherent in private insurance billing. Because balance billing can occur when services are provided by out-of-network providers or ancillary services, patients should be aware of their rights under the No Surprises Act, which protects against unexpected bills for emergency care and non-emergency services at in-network facilities. If a balance bill is received, patients should dispute it with their insurer rather than paying immediately, and should always request a detailed, itemized bill to identify any errors or unbundled charges before finalizing payment.