MRI, brain (with and without contrast)
Facility: Lindsborg Community Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $5,177
- Cash Discount Price: $3,960
- vs. Medicare Baseline: 14.52x 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 1452% of the Medicare baseline (a markup of 1352%). 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 | $521 | 146% |
| Tricare | $2,659 | 746% |
| Coventry Mcr Adv | $2,686 | 754% |
| Cigna | $4,809 | 1349% |
| UnitedHealthcare | $5,092 | 1429% |
| Coventry Comm-All Other Plans | $5,092 | 1429% |
| Multiplan-All Plans | $5,262 | 1476% |
| Phcs Preferred-All Plans | $5,262 | 1476% |
| Century Health-All Plans | $5,375 | 1508% |
| Health Partners -All Plans | $5,375 | 1508% |
| Wppa-All Plans | $5,375 | 1508% |
| Coventry Wc | $5,375 | 1508% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Lindsborg Community Hospital in Lindsborg, KS, the facility's cash median price of $3,960 is lower than the negotiated rates paid by most insurance plans, which range from $521 for Blue Cross Blue Shield up to $5,375 for several other carriers. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, the data indicates a significant variance in pricing depending on the payer; for instance, Tricare pays $2,659, which is substantially lower than the cash price, suggesting that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash rate directly could result in lower total costs compared to the insurance negotiated ceiling. It is important to note that the facility's cash price is also lower than the state average implied by the higher commercial negotiated rates, but patients should verify if their specific plan has a lower allowed amount before assuming the cash rate is the best option.
The facility's Medicare benchmarking data shows a Medicare amount of $356.43, which serves as a baseline for evaluating the markup on this service. The median negotiated rate of $5,177 and the median paid rate of $5,262 are significantly higher than the Medicare amount, reflecting the typical administrative and contractual structures that inflate commercial rates. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, they should still request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final statement. Additionally, since the hospital offers prompt