MRI, brain (with and without contrast)
Facility: Clay County Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $219
- Cash Discount Price: $1,841
- vs. Medicare Baseline: 0.61x 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 |
|---|---|---|
| Health Partners - All Plans | $75 - $3,280 | 21% |
| Multiplan- All Plans | $107 - $3,280 | 30% |
| UnitedHealthcare | $140 - $3,280 | 39% |
| Aetna | $214 - $3,211 | 60% |
| Wppa/Providrs Care- All Plans | $214 - $3,211 | 60% |
Consumer Guidance & Cost Commentary
For the MRI of the brain at Clay County Medical Center in Clay Center, KS, the cash price is $1,841, which matches the facility's median paid amount. This cash rate is significantly higher than the state average for this procedure, though specific county averages were not provided in the data. While commercial insurance plans like Health Partners, Multiplan, and UnitedHealthcare negotiate rates up to $3,280, these figures often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the negotiated amounts allowed by insurers can sometimes be substantially higher than the self-pay price. To secure the lowest possible cost, it is essential to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available before scheduling the appointment.
The facility's Medicare benchmarking rate is $356.43, which serves as a critical baseline for evaluating pricing fairness. Commercial negotiated rates for this service average between $219 and $3,280 depending on the payer, with the median negotiated amount listed at $219. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like emergency physicians or lab tests are billed separately. If a patient receives an itemized bill, they should request a full line-by-line audit to identify any unbundled codes, services not rendered, or errors, as over 80% of hospital bills contain inaccuracies. Disputing charges in writing rather than verbally ensures that corrections are properly documented and processed.