MRI, brain (with and without contrast)
Facility: Wilson Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $824
- Cash Discount Price: $773
- vs. Medicare Baseline: 2.31x 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 231% of the Medicare baseline (a markup of 131%). 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 | $521 - $1,030 | 146% |
| Tricare | $546 | 153% |
| Humana | $546 | 153% |
| UnitedHealthcare | $546 - $958 | 153% |
| Aetna | $546 - $1,030 | 153% |
| Ambetter / Centene | $546 - $1,030 | 153% |
| Cigna | $824 | 231% |
| Mulitplan-All Plans | $948 | 266% |
| Health Partners-All Plans | $948 | 266% |
Consumer Guidance & Cost Commentary
For the MRI of the brain at Wilson Medical Center in Neodesha, KS, the facility's cash median rate of $773.00 is significantly higher than the state average, which sits at $356.43. While the Medicare benchmark of $356.43 serves as the objective baseline for evaluating pricing markups, patients should note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this case, the median negotiated rate is $824.00, which is higher than the cash price. This dynamic suggests that for patients with high-deductible plans, paying the cash price directly may result in lower out-of-pocket costs compared to using insurance, provided the patient has met their deductible.
The facility offers a range of negotiated rates across nine payers, with the lowest allowed amount being $521.00 from Blue Cross Blue Shield and the highest at $1030.00 from Aetna, Ambetter/Centene, and UnitedHealthcare. Because these rates are contractually agreed-upon ceilings, they do not necessarily represent the lowest possible price available. Patients are encouraged to verify their specific plan's allowed amount before scheduling and to explicitly request a "self-pay" or "prompt-pay" discount from the billing department, which can reduce the total cost by 20% to 50%. Additionally, since the facility is a Critical Access Hospital with government local ownership, patients should review their itemized bill carefully to ensure no errors or unbundled charges are present before finalizing payment.