MRI, brain (with and without contrast)
Facility: Scott County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,237
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.47x 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 347% of the Medicare baseline (a markup of 247%). 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 | $207 - $1,959 | 58% |
| Blue Cross Blue Shield | $553 | 155% |
| Humana | $866 | 243% |
| Wppa | $1,200 - $1,237 | 337% |
| Aetna | $1,856 | 521% |
Consumer Guidance & Cost Commentary
For CPT code 70553, MRI of the brain with and without contrast, Scott County Hospital in Scott City, KS, has a gross charge of $2,062.00. While the facility's negotiated rates range from $207 to $1,959 depending on the insurance carrier, the cash median is not available in the current data. It is important to note that cash-pay options can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. Before scheduling, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer significant fee reductions for upfront payment. Additionally, since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice to ensure no unbundled charges or services not rendered are included.
The Medicare benchmark for this procedure is $356.43, which serves as a scientifically validated baseline for evaluating pricing markups. The facility's negotiated rates are significantly higher than this Medicare amount, reflecting the administrative costs and contract dynamics inherent in commercial insurance billing. While the data does not provide specific cash or state/county average comparisons for this exact code, understanding that commercial rates often average 200% to 300% of Medicare helps contextualize the billed amount. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act, and they should verify their deductible status before relying on insurance to cover these costs.