MRI, brain (with and without contrast)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $756
- Cash Discount Price: $786
- vs. Medicare Baseline: 2.12x 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 $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 212% of the Medicare baseline (a markup of 112%). 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 | 127% |
| Tricare | $489 | 137% |
| Va Ccn - All Plans | $574 | 161% |
| Aetna | $574 - $832 | 161% |
| Medicaid / KanCare | $574 - $925 | 161% |
| UnitedHealthcare | $574 - $925 | 161% |
| Ambetter / Centene | $631 | 177% |
| Blue Cross Blue Shield | $756 | 212% |
| Health Partners - All Plans | $879 | 247% |
| Healthy Blue Mcaid - All Plans | $925 | 260% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Trego County Lemke Memorial Hospital in Wakeeney, KS, the facility's cash price of $786.00 is notably higher than the state average of $574.00, though it aligns closely with the county average of $756.00. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $574 to $925, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that the facility's government ownership and Critical Access Hospital status may influence these pricing structures, and patients should verify their specific plan's allowed amount before scheduling to ensure they are not being billed above the negotiated ceiling.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the administrative costs associated with insurance claims. Additionally, since the facility's Medicare benchmark of $356.43 serves as a reliable baseline for fair pricing, the commercial negotiated rates reflect a significant markup common in the healthcare system. Consumers are advised to request a full itemized bill before payment to identify any errors or unbundled charges, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute rather than accepting a summary invoice.