MRI, brain (with and without contrast)
Facility: Osborne County Memorial Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,272
- Cash Discount Price: $1,194
- vs. Medicare Baseline: 3.57x 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 357% of the Medicare baseline (a markup of 257%). 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 |
|---|---|---|
| UnitedHealthcare | $1,068 | 300% |
| Health Partners Of Kansas | $1,208 | 339% |
| Wppa | $1,335 | 375% |
| Blue Cross Blue Shield | $1,377 | 386% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash price of $1,194.00 is notably higher than the state average, which sits at $1,068.00. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates for this service range from $1,068.00 to $1,377.00 depending on the payer. In many cases, paying the cash price directly can be more cost-effective than using insurance, especially for those with high-deductible plans, because the insurance negotiated rate often exceeds the cash price due to administrative overhead and contract dynamics.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid upfront, bypassing the administrative costs associated with insurance claims. It is also important to compare the facility's pricing against the Medicare benchmark of $356.43; the commercial rates are significantly higher, reflecting the markup typical of private insurance contracts. Before scheduling, consumers are advised to request an itemized bill to ensure no errors exist and to confirm whether any ancillary services might trigger balance billing, though the No Surprises Act protects against such charges for out-of-network providers at in-network facilities.