MRI, brain (with and without contrast)
Facility: Morris County Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $1,505
- Cash Discount Price: $2,315
- vs. Medicare Baseline: 4.22x 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 422% of the Medicare baseline (a markup of 322%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $404 | 113% |
| Blue Cross Blue Shield | $525 - $1,505 | 147% |
| Coventry Mcr | $1,505 | 422% |
| Choice Care Mcr Adv-All Plans | $1,505 | 422% |
| UnitedHealthcare | $1,505 - $3,859 | 422% |
| Va Ccn-All Plans | $1,505 | 422% |
| Cigna | $2,792 | 783% |
| Aetna | $3,458 | 970% |
| Coventry Comm-All Other Plans | $3,473 | 974% |
| Multiplan-All Plans | $3,473 | 974% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Morris County Hospital in Council Grove, KS, the facility's cash median price is $2,315, which is significantly lower than the negotiated rates paid by most major insurers. While the facility's gross charge is $3,859, commercial payers like UnitedHealthcare and Cigna have negotiated rates ranging from $1,505 to $3,473, often exceeding the cash price. This pricing structure highlights the potential benefit of paying out-of-pocket, as patients with high-deductible plans may save money by selecting the cash rate of $2,315 rather than relying on insurance, which could result in a higher allowed amount. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing costs.
The facility's pricing also compares favorably against federal benchmarks, with a Medicare amount of $356.43 and a vs. Medicare ratio of 4.2, indicating the commercial rates are substantially higher than the government baseline. Although the facility is a Critical Access Hospital with government-local ownership, the wide variance in negotiated rates across different insurers suggests that network status does not guarantee the lowest price. Patients should be cautious of balance billing if they receive care from out-of-network providers, even at an in-network facility, and should always demand a detailed, itemized bill rather than accepting a summary invoice. If a large bill arrives, it is advisable to dispute any errors in writing and verify that no unnecessary charges were included before making a payment.