MRI, brain (with and without contrast)
Facility: Lincoln County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $553
- Cash Discount Price: $1,240
- vs. Medicare Baseline: 1.55x 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.
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 | $553 | 155% |
Consumer Guidance & Cost Commentary
For this MRI of the brain at Lincoln County Hospital in Lincoln, KS, the cash price is $1,240, which is lower than the negotiated rate of $553 charged by Blue Cross Blue Shield. This suggests that if you have a high-deductible plan, paying cash upfront might be more cost-effective than using insurance, as the negotiated rate exceeds the cash price. However, patients should verify their specific plan's deductible status before deciding, as paying with insurance may cover costs after the deductible is met. Additionally, you can often reduce the cash price by asking the hospital for a "self-pay" or "prompt-pay" discount before scheduling your visit, as these incentives can lower the final amount owed.
The facility's pricing is significantly higher than the Medicare benchmark of $356.43 for this procedure, with a ratio of 1.6 times the Medicare rate. While commercial rates often average 200% to 300% of Medicare, the negotiated rate here is already below the typical commercial markup, though still above the Medicare baseline. If you receive a bill that includes charges for out-of-network services or emergency care at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for these specific scenarios. To ensure accuracy, always request an itemized bill that lists every CPT code and service rendered, as summary bills can hide errors or unbundled charges that should not be billed separately.