MRI, brain (with and without contrast)
Facility: Hodgeman County Health Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,806
- Cash Discount Price: $2,052
- vs. Medicare Baseline: 5.07x 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 507% of the Medicare baseline (a markup of 407%). 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 | $500 - $526 | 140% |
| Medicaid / KanCare | $1,642 - $2,565 | 461% |
| UnitedHealthcare | $1,642 - $2,437 | 461% |
| Humana | $1,642 | 461% |
| Triwest - All Plans | $1,642 | 461% |
| Aetna | $2,052 | 576% |
| First Health - All Plans | $2,308 | 648% |
| Health Partners - All Plans | $2,437 | 684% |
| Wppa (Provdrscare) - All Plans | $2,437 | 684% |
Consumer Guidance & Cost Commentary
For the MRI of the brain with and without contrast at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price is $2,052, which is significantly higher than the state average of $2,052 and the county average of $2,052. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, Blue Cross Blue Shield's negotiated rate ranges from $500 to $526, while Medicaid/KanCare, UnitedHealthcare, and Humana all have negotiated rates starting at $1,642. In cases where a patient has a high deductible or limited insurance coverage, paying the cash price directly can sometimes be more cost-effective than relying on insurance, provided the negotiated rate exceeds the cash amount.
To minimize costs, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. It is also important to request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed. When evaluating the facility's pricing against the Medicare benchmark of $356.43 for this procedure, the cash price represents a substantial markup, highlighting the importance of comparing rates to the federal baseline rather than the hospital's full chargemaster. Finally, if you have insurance, verify your deductible status before scheduling, as paying out-of-pocket may be necessary if your plan has