MRI, brain (no contrast)
Facility: Phillips County Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $742
- Cash Discount Price: $697
- vs. Medicare Baseline: 3.04x 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 304% of the Medicare baseline (a markup of 204%). 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 | $553 - $664 | 227% |
| UnitedHealthcare | $656 - $820 | 269% |
| Medicaid / KanCare | $820 | 336% |
| Health Partners-All Plans | $820 | 336% |
Consumer Guidance & Cost Commentary
For this MRI of the brain (no contrast) at Phillips County Hospital in Phillipsburg, KS, the facility's cash median price is $697.00, which is lower than the negotiated rates paid by most commercial insurers. While the gross charge listed is $820.00, patients with high-deductible plans or those without insurance may find paying cash directly more cost-effective, as the cash price is significantly lower than the average negotiated rates of $742.00 to $820.00 seen with UnitedHealthcare and Medicaid/KanCare. It is important to note that cash payments can sometimes be cheaper than insurance reimbursement if the patient's deductible has not yet been met, so verifying your specific plan's allowed amount before scheduling is essential.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $243.77, which serves as a scientifically validated baseline for the true cost of delivery. The facility's cash rate of $697.00 represents a markup of approximately 286% over the Medicare rate, which aligns with the typical range where commercial rates average 200% to 300% of Medicare. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, since this is a Critical Access Hospital, you should request a detailed, itemized bill to ensure no errors or unbundled charges are included before finalizing payment.