MRI, brain (no contrast)
Facility: Girard Medical Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $1,155
- Cash Discount Price: $1,980
- vs. Medicare Baseline: 4.74x 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 474% of the Medicare baseline (a markup of 374%). 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 | $553 - $1,155 | 227% |
| Ambetter / Centene | $1,155 | 474% |
| Aetna | $1,155 - $5,775 | 474% |
| UnitedHealthcare | $1,155 - $3,135 | 474% |
| Humana | $1,155 | 474% |
| Medicare (plans) | $1,155 | 474% |
| Kansas Superior Select-All Plans | $1,155 | 474% |
| Multiplan-All Plans | $3,052 | 1252% |
| Uhhis-All Plans | $3,135 | 1286% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Girard Medical Center in Kansas, the cash price of $1,980 is notably higher than the state average of $1,155, though it remains below the facility's gross charge of $3,300. While the facility is a Critical Access Hospital owned by a government hospital district, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, the median negotiated rate across payers is $1,155, which is lower than the cash price, but this does not guarantee the lowest possible cost for every patient. If you have a high-deductible plan, paying the cash price of $1,980 upfront might be more cost-effective than relying on insurance, especially if your deductible has not yet been met or if the insurer's allowed amount is significantly lower than the cash rate.
To maximize savings, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Since hospitals often charge different rates to different insurance plans, it is crucial to verify the specific allowed amount for your plan rather than assuming the in-network rate is the best price. Additionally, if you receive an itemized bill, ensure it includes a full breakdown of CPT codes to identify any errors, double-billing, or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit. Always request a waiver of insurance submission if you choose to pay cash to avoid automatic claims processing that could void any potential discounts.