MRI, brain (with and without contrast)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,087
- Cash Discount Price: $1,988
- vs. Medicare Baseline: 3.05x 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 305% of the Medicare baseline (a markup of 205%). 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 | $553 | 155% |
| Aetna | $742 - $1,772 | 208% |
| UnitedHealthcare | $922 - $1,352 | 259% |
Consumer Guidance & Cost Commentary
For the MRI of the brain with and without contrast at Community Memorial Healthcare, Inc. in Marysville, KS, the cash median price is $1,988.00, which matches the facility's gross charge. This amount is significantly higher than the Medicare benchmark of $356.43, indicating a markup of 300% relative to the federal government's fixed reimbursement rate. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, Aetna's negotiated range spans from $742 to $1,772, and UnitedHealthcare's range is $922 to $1,352, both of which can be higher than the cash-pay option depending on the specific plan tier.
Patients with high-deductible plans may find it financially advantageous to pay the cash median of $1,988.00 directly, as this could be lower than their specific insurance allowed amount or the final bill after deductibles are applied. It is crucial to verify your deductible status before scheduling, as paying out-of-pocket might save money if the insurance negotiated rate exceeds the cash price. Additionally, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled upfront. Since over 80% of hospital bills contain errors, do not accept a summary bill as final; instead, request a detailed itemized statement to ensure no unbundled codes or services not rendered are included before making any payment.