MRI, brain (with and without contrast)
Facility: Stanton County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $2,495
- Cash Discount Price: $2,625
- vs. Medicare Baseline: 7.00x 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 700% of the Medicare baseline (a markup of 600%). 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 - $2,495 | 147% |
| Healthy Blue Mcr Adv - All Other Plans | $2,572 | 722% |
| Healthy Blue Mcaid | $2,625 | 736% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Stanton County Hospital in Johnson, KS, the cash price is $2,625.00, which matches the facility's negotiated rate with Healthy Blue Mcaid and the high-end of the range for Blue Cross Blue Shield. While the median amount paid by insurers was $2,534.00, patients with high-deductible plans may find paying the cash price directly more economical if their insurance negotiated rate exceeds this amount, as the cash rate here is identical to the lowest negotiated rate available. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final cost by bypassing administrative billing cycles.
This service is benchmarked against the national Medicare rate of $356.43, revealing a significant markup typical of commercial pricing structures where negotiated rates often range from 200% to 300% of the Medicare baseline. Although the data does not provide specific county or state average comparisons for this code, the facility's gross charge of $2,625.00 serves as the starting point for any balance billing scenarios if a patient receives out-of-network care. To avoid unexpected costs, consumers should request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If a balance bill arises from an out-of-network provider, patients should verify its legality under the No Surprises Act before making immediate payment, and always dispute any