MRI, brain (with and without contrast)
Facility: Memorial Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $3,112
- Cash Discount Price: $5,658
- vs. Medicare Baseline: 8.73x 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 873% of the Medicare baseline (a markup of 773%). 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 | 156% |
| Tricare | $2,829 | 794% |
| Humana | $2,829 | 794% |
| Medicare (plans) | $2,857 | 802% |
| Ambetter / Centene | $3,112 | 873% |
| Coventry - All Other Plans | $5,092 | 1429% |
| Health Partners Of Kansas - All Plans | $5,375 | 1508% |
| Preferred Healthcare-All Plans | $5,375 | 1508% |
| Wppa/Providers Care-All Plans | $7,921 | 2222% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Memorial Hospital in Abilene, KS, the cash price of $5,658 is significantly higher than the median negotiated rate of $3,112 paid by insurers like Ambetter/Centene. While the facility is a Critical Access Hospital with a government ownership structure, the cash price remains the highest among the nine payers listed, ranging from $556 for Blue Cross Blue Shield to $7,921 for Wppa/Providers Care. Patients with high-deductible plans should consider that paying the cash price directly might be more cost-effective than relying on insurance, as the negotiated rates for many commercial payers exceed the cash rate. It is crucial to verify if the facility offers 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.
When reviewing your final invoice, ensure you receive an itemized bill rather than a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Comparing this charge to the Medicare benchmark of $356.43 reveals a substantial markup, which is typical for commercial pricing but highlights the importance of understanding the true cost basis. If you receive a balance bill for the difference between the provider's chargemaster and your insurance allowed amount, you may be protected under the No Surprises Act for non-emergency services at in-network facilities. Always request a formal written audit dispute via certified mail if you identify discrepancies, avoiding verbal settlements that may not be entered into the billing system correctly.