MRI, brain (no contrast)
Facility: St Luke Hospital & Living Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $1,427
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.85x 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 585% of the Medicare baseline (a markup of 485%). 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 |
|---|---|---|
| Va Ccn | $1,427 | 585% |
| Kansas Department Of Health And Environment | $1,427 | 585% |
| Humana | $1,427 | 585% |
| UnitedHealthcare | $1,427 | 585% |
| Blue Cross Blue Shield | $1,427 | 585% |
| Bluestem Pace | $1,427 | 585% |
| Ambetter / Centene | $1,442 | 592% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $1,427, which matches the lowest and highest amounts reported across seven payers including Humana and UnitedHealthcare. This negotiated rate is significantly higher than the Medicare benchmark of $243.77, reflecting the standard administrative markup inherent in commercial insurance contracts. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find that paying the cash price directly could result in lower out-of-pocket costs, as the cash rate is not explicitly listed but is often lower than the negotiated insurance amount. It is important to note that while the facility offers prompt-pay discounts to reduce administrative costs and improve cash flow, these discounts must be requested before scheduling to avoid automatic claims submission that would void the cash agreement.
The pricing data for this service does not include a specific cash median or state average for comparison, so direct comparisons with county or state averages are not available in the current report. However, the consistent $1,427 rate across all seven payers indicates a uniform negotiated ceiling that protects in-network members from balance billing, a practice that is generally prohibited for emergency care and non-emergency services at in-network facilities under federal law. Patients should be aware that hospitals often issue summary bills that obscure individual charges; to ensure accuracy and avoid errors such as double-billing or unbundled codes, it is advisable to request a full itemized CPT-coded statement before finalizing payment. If a patient chooses to pay out-of-network or self-pay, they should verify the facility's specific self-pay or prompt-pay discount policies directly with