MRI, brain (no contrast)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $756
- Cash Discount Price: $786
- vs. Medicare Baseline: 3.10x 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 310% of the Medicare baseline (a markup of 210%). 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 |
|---|---|---|
| Humana | $453 | 186% |
| Tricare | $489 | 201% |
| UnitedHealthcare | $574 - $925 | 235% |
| Aetna | $574 - $832 | 235% |
| Va Ccn - All Plans | $574 | 235% |
| Medicaid / KanCare | $574 - $925 | 235% |
| Ambetter / Centene | $631 | 259% |
| Blue Cross Blue Shield | $756 | 310% |
| Health Partners - All Plans | $879 | 361% |
| Healthy Blue Mcaid - All Plans | $925 | 379% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Trego County Lemke Memorial Hospital, the facility's cash price of $786.00 is notably higher than the state average of $574.00, though it aligns with the county average for this service. While the facility is a Critical Access Hospital in Wakeeney, KS, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. Specifically, UnitedHealthcare and Medicaid/KanCare plans have negotiated ranges that reach up to $925.00, which is the same as the gross chargemaster, meaning in-network members could potentially pay more than a self-pay patient.
To minimize costs, patients should verify their specific plan's negotiated rate before scheduling, as some commercial payers may offer rates closer to the cash price or even lower depending on network tiering. Additionally, since the facility is government-owned, patients should explicitly ask about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims. It is also important to request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.