MRI, brain (no contrast)
Facility: Memorial Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $2,348
- Cash Discount Price: $4,270
- vs. Medicare Baseline: 9.63x 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 963% of the Medicare baseline (a markup of 863%). 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 | $556 | 228% |
| Humana | $2,135 | 876% |
| Tricare | $2,135 | 876% |
| Medicare (plans) | $2,156 | 884% |
| Ambetter / Centene | $2,348 | 963% |
| Coventry - All Other Plans | $3,843 | 1576% |
| Preferred Healthcare-All Plans | $4,056 | 1664% |
| Health Partners Of Kansas - All Plans | $4,056 | 1664% |
| Wppa/Providers Care-All Plans | $5,977 | 2452% |
Consumer Guidance & Cost Commentary
For this MRI of the brain (no contrast) at Memorial Hospital in Abilene, KS, the cash price is $4,270, which matches the facility's gross charge and the state average. While commercial insurance plans like Humana and Tricare negotiate a payment of $2,135, and Medicare allows $243.77, patients with high-deductible plans may find paying cash directly to be the most cost-effective option. This is because the negotiated rates for many insurers exceed the cash price, meaning the patient would pay more out-of-pocket if they relied on insurance coverage without meeting their deductible first.
The facility is a Critical Access Hospital with a government ownership structure, and while the median negotiated rate across payers is $2,348, the cash price remains the lowest available figure at $4,270. Patients should verify their specific plan's allowed amount before scheduling, as some commercial payers may have higher negotiated rates than the cash price. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if paid in full upfront, bypassing the administrative costs and potential balance billing associated with insurance claims.