MRI, brain (no contrast)
Facility: Sheridan County Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $761
- Cash Discount Price: $854
- vs. Medicare Baseline: 3.12x 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 312% of the Medicare baseline (a markup of 212%). 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 |
|---|---|---|
| Celtic Insurance | $517 | 212% |
| Blue Cross Blue Shield | $761 | 312% |
| UnitedHealthcare | $811 | 333% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Sheridan County Hospital in Hoxie, KS, the cash price is $854.00, which matches the facility's median negotiated rate of $761.00. While the gross charge listed is $854.00, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price is identical to the negotiated rate, meaning there is no financial advantage to paying out-of-pocket if you have insurance coverage. However, if your plan has a high deductible, paying the cash price directly could save you money compared to your insurer's allowed amount, provided you have the funds available.
The Medicare benchmark for this service is $243.77, which serves as the objective baseline for evaluating pricing markups. Commercial rates, including the negotiated rate of $761.00, are significantly higher than this federal baseline, reflecting the standard markup found in the healthcare industry. To ensure you are receiving the best possible rate, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, since this facility is a Critical Access Hospital with government-local ownership, verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected balance billing or surprise costs.