MRI, brain (with and without contrast)
Facility: Fredonia Regional Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $836
- Cash Discount Price: $929
- vs. Medicare Baseline: 2.35x 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 235% of the Medicare baseline (a markup of 135%). 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 | $460 - $553 | 129% |
| Aetna | $474 - $836 | 133% |
| Veterans Programs - All Plans | $474 | 133% |
| UnitedHealthcare | $474 - $836 | 133% |
| Meritain-All Plans | $836 | 235% |
| Cigna | $836 | 235% |
| Reserve National-All Plans | $836 | 235% |
Consumer Guidance & Cost Commentary
For the MRI of the brain procedure at Fredonia Regional Hospital in Kansas, the cash price is $929.00, which matches the facility's median negotiated rate of $836.00. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $474 to $836, the cash price remains the highest figure in this dataset. It is important to note that for patients with high-deductible plans, paying the cash price of $929.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash price. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill.
This facility is a Critical Access Hospital in the state of Kansas, and its pricing is benchmarked against federal standards. The Medicare amount for this service is $356.43, which serves as the objective baseline for evaluating the facility's markup. Commercial rates, including the cash price of $929.00, are significantly higher than the Medicare rate, reflecting the administrative costs and contract structures of commercial insurance. To ensure you are receiving the most accurate pricing, it is recommended to request a full itemized bill rather than accepting a summary invoice, as this allows you to verify that all charges are correct and prevents unexpected errors.