MRI, brain (no contrast)
Facility: Hiawatha Community Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $2,074
- Cash Discount Price: $2,663
- vs. Medicare Baseline: 8.51x 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 851% of the Medicare baseline (a markup of 751%). 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 | $525 - $553 | 215% |
| UnitedHealthcare | $985 - $2,288 | 404% |
| Aetna | $985 - $2,152 | 404% |
| Humana | $995 | 408% |
| Ambetter / Centene | $1,182 | 485% |
| Centrus Health Direct - All Plans | $1,997 | 819% |
| Oscar - All Plans | $1,997 | 819% |
| Preferred Hlth - All Plans | $2,397 | 983% |
| Cigna | $2,530 | 1038% |
| Wppa Providrs Care - All Plans | $2,530 | 1038% |
| Multiplan - All Plans | $2,583 | 1060% |
| Midlands Choice - All Plans | $2,583 | 1060% |
| Healthy Blue Mcaid - All Plans | $2,663 | 1092% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (no contrast) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $2,663.00, which matches the facility's negotiated rate for most major insurers. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the cash price is significantly higher than the state average for this service. Patients with high-deductible plans may find it beneficial to pay the cash price directly, as it is lower than the negotiated rates charged to many in-network payers, such as Cigna, Wppa Providers Care, and Multiplan, which all list rates at $2,530.00 to $2,583.00. However, for those with lower deductibles or those who have already met their out-of-pocket maximum, using insurance is likely more cost-effective, as the median allowed amount across all plans is $1,997.00.
To ensure you are receiving the best possible rate, it is important to understand that commercial insurance rates often include administrative overhead and do not represent the true cost of care. The Medicare benchmark for this procedure is $243.77, which serves as a scientifically validated baseline for the actual cost of delivery; commercial rates are typically marked up significantly above this figure. If you choose to pay out-of-network or if your insurance denies a claim, you may face balance billing, where the hospital bills you for the difference between the full chargemaster rate and what your insurer paid. To avoid unexpected costs, always request a prompt-pay discount or self-pay rate before scheduling, as these can reduce the bill by 20% to 50