MRI, brain (with and without contrast)
Facility: Amberwell Atchison Association
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $2,075
- Cash Discount Price: $4,515
- vs. Medicare Baseline: 5.82x 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 582% of the Medicare baseline (a markup of 482%). 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 | $525 - $553 | 147% |
| Humana | $970 - $1,490 | 272% |
| UnitedHealthcare | $1,490 - $8,101 | 418% |
| Va Ccn - All Plans | $1,490 | 418% |
| Superior Select Mcr Adv - All Plans | $1,490 | 418% |
| Triwest - All Plans | $1,490 | 418% |
| Ambetter / Centene | $2,309 | 648% |
| Aetna | $2,483 | 697% |
| Cigna | $2,483 | 697% |
| Centrus Health Direct - All Plans | $3,386 | 950% |
| Oscar - All Plans | $3,386 | 950% |
| Multiplan - All Plans | $3,522 | 988% |
| Wppa Providrs Care - All Plans | $4,064 | 1140% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Amberwell Atchison Association, the cash price is $4,515, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a 5.8% variance compared to Medicare benchmarks. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates ranging from $525 to $1,490, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash rate directly can be more cost-effective than relying on insurance, provided the patient qualifies for a prompt-pay discount. Patients should contact the hospital before scheduling to request a self-pay classification and inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% when paid in full upfront.
Although the facility is a Voluntary non-profit Critical Access Hospital in Atchison, KS, and is in-network for most major payers, patients must remain vigilant regarding balance billing and itemized audits. The No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but it is essential to review the full itemized bill to ensure no unbundled codes or services not rendered are included. If a discrepancy is found, a formal written audit dispute should be sent to the billing supervisor rather than settling verbally. Additionally, while the facility's negotiated rates vary widely among payers, with UnitedHealthcare showing a high-end range up to $8,101, patients should verify their specific deductible status and allowed amounts before proceeding to avoid unexpected out-of-pocket costs.