MRI, brain (no contrast)
Facility: Fredonia Regional Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $783
- Cash Discount Price: $870
- vs. Medicare Baseline: 3.21x 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 $243.77 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 321% of the Medicare baseline (a markup of 221%). 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 | $430 - $553 | 176% |
| UnitedHealthcare | $444 - $783 | 182% |
| Aetna | $444 - $783 | 182% |
| Veterans Programs - All Plans | $444 | 182% |
| Meritain-All Plans | $783 | 321% |
| Reserve National-All Plans | $783 | 321% |
| Cigna | $783 | 321% |
Consumer Guidance & Cost Commentary
For this MRI of the brain without contrast at Fredonia Regional Hospital in Fredonia, Kansas, the cash price is $870.00, which matches the facility's median negotiated rate of $783.00 and the state average. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance plans like Blue Cross Blue Shield, UnitedHealthcare, and Aetna negotiate rates ranging from $430 to $783, depending on the specific plan. Because the cash price aligns with the median negotiated amount, paying out-of-pocket may not offer a financial advantage over using insurance, though patients with high deductibles might still find the cash option simpler if their insurance allowed amount exceeds the cash price. It is always advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling.
The Medicare benchmark for this service is $243.77, indicating that the cash price of $870.00 represents a 3.2x markup relative to the federal baseline. This significant difference highlights why comparing rates to the Medicare amount is more accurate than looking at the hospital's gross charges or commercial negotiated rates, which often include administrative overhead and contract dynamics that inflate the final cost. If a patient receives an itemized bill later, they should request a full line-by-line audit to ensure no errors, unbundled codes, or services not rendered are included, as over 80% of hospital bills contain discrepancies. Furthermore, under the No Surprises Act, patients are protected from balance billing for emergency care or non-emergency services from out-of-network providers at in-network facilities, so