MRI, brain (no contrast)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $810
- Cash Discount Price: $720
- vs. Medicare Baseline: 3.32x 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 332% of the Medicare baseline (a markup of 232%). 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 | 203% |
| UnitedHealthcare | $810 - $900 | 332% |
| Providers Care (Wppa)-All Plans | $1,575 | 646% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price of $720.00 is notably lower than the median negotiated rate of $810.00 paid by UnitedHealthcare and Providers Care. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash amount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.
The Medicare benchmark for this service is $243.77, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific state or county average comparisons for this CPT code, the facility's cash rate of $720.00 represents a significant markup over the federal government's calculated cost basis. Consumers are advised to avoid accepting summary bills as final invoices, as hospitals often issue broad category totals that obscure individual charges; instead, request a full itemized CPT-coded bill to identify any errors, unbundled codes, or services not rendered. If a balance bill or unexpected charge arises, patients should dispute the bill in writing with the billing supervisor rather than paying immediately, and ensure they do not sign away their rights to dispute out-of-network ancillary services through consent waivers.