MRI, brain (no contrast)
Facility: William Newton Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $930
- Cash Discount Price: $2,583
- vs. Medicare Baseline: 3.82x 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 $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 382% of the Medicare baseline (a markup of 282%). 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 - $930 | 215% |
| Triwest- All Plans | $902 | 370% |
| UnitedHealthcare | $930 - $2,325 | 382% |
| Ambetter / Centene | $930 - $2,583 | 382% |
| Providrs Care Nexus | $1,581 | 649% |
| Providrs Care - All Other Plans | $1,808 | 742% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at William Newton Hospital in Winfield, KS, the cash price is $2,583, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average for this service, though it aligns closely with the Medicare benchmark of $243.77, indicating a substantial markup relative to federal reimbursement standards. While commercial insurance plans like Blue Cross Blue Shield and Triwest-All Plans have negotiated rates ranging from $525 to $930, these amounts are often lower than the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly, provided they secure a prompt-pay discount before the insurance claim is processed.
Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but it is crucial to verify network status and request a waiver of insurance submission to avoid unexpected charges. Since over 80% of hospital bills contain errors, consumers are advised to request a full itemized CPT-coded bill before paying, rather than accepting a summary invoice that may hide unbundled codes or services not rendered. If you are self-paying, ask the billing department specifically about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, effectively bypassing the administrative overhead and collection fees associated with the insurance billing cycle.