MRI, brain (with and without contrast)
Facility: Minneola District Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,392
- Cash Discount Price: $734
- vs. Medicare Baseline: 3.91x 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 391% of the Medicare baseline (a markup of 291%). 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 Community Care Program-All Plans | $101 - $1,227 | 28% |
| UnitedHealthcare | $101 - $1,831 | 28% |
| Humana | $101 - $1,227 | 28% |
| Medicaid / KanCare | $311 - $1,831 | 87% |
| Providrs Care Network-All Plans | $311 - $1,556 | 87% |
| Aetna | $311 - $1,831 | 87% |
| Blue Cross Blue Shield | $526 | 148% |
| Corporate Plan Management-All Plans | $1,556 | 437% |
| Triwest-All Plans | $1,648 | 462% |
| Preferred Health Care (Coventry)-All Other Plans | $1,648 | 462% |
| Phc (Coventry) Leased Network | $1,739 | 488% |
| Health Partners Of Kansas-All Plans | $1,739 | 488% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Minneola District Hospital, the cash median price is $734.00, which is significantly lower than the facility's negotiated rate of $1,648.00 and the median negotiated rate of $1,392.00 across payers. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $101 to $1,831, patients with high-deductible plans may find paying cash directly more cost-effective, as the cash price of $734.00 is well below the average commercial negotiated amount. To maximize savings, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative fees associated with insurance claims processing.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $356.43 for this service. The commercial negotiated rates observed at this Critical Access Hospital in Minneola, KS, average 3.9 times the Medicare amount, reflecting the standard markup structure where commercial rates often exceed 200% of the Medicare baseline due to administrative costs and contract dynamics. Since the facility is a Government-owned Hospital District, patients should be aware that while the facility offers a wide range of payer-specific rates, the most transparent and often lowest-cost option remains the cash price, provided the patient has no other coverage or meets the deductible threshold for their specific plan.