MRI, brain (with and without contrast)
Facility: St Luke Hospital & Living Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,784
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.01x 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 501% of the Medicare baseline (a markup of 401%). 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 | $1,784 | 501% |
| Kansas Department Of Health And Environment | $1,784 | 501% |
| UnitedHealthcare | $1,784 | 501% |
| Bluestem Pace | $1,784 | 501% |
| Humana | $1,784 | 501% |
| Blue Cross Blue Shield | $1,784 | 501% |
| Ambetter / Centene | $1,802 | 506% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate of $1,784 is consistent across all seven major payers, including UnitedHealthcare, Humana, and Blue Cross Blue Shield. This rate is significantly higher than the Medicare benchmark of $356.43, which serves as the objective baseline for healthcare costs. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and network tiering, patients with high-deductible plans should consider that paying cash directly might be cheaper if the facility offers a self-pay or prompt-pay discount. It is important to verify these cash rates before scheduling, as the facility's cash price is not listed in the current data, but asking for a prompt-pay discount could bypass the administrative costs embedded in the insurance negotiated rate.
Patients should be aware that the No Surprises Act protects them from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, meaning they should not pay surprise bills immediately without disputing them with their insurer. Additionally, since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice to identify any unbundled codes or services not rendered. If you have questions about your specific deductible status or plan coverage, please contact the hospital directly to confirm whether your insurance will cover the full negotiated amount or if you might qualify for a reduced cash rate.