MRI, brain (no contrast)
Facility: Bob Wilson Memorial Hospital
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $2,756
- Cash Discount Price: $1,350
- vs. Medicare Baseline: 11.31x 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 1131% of the Medicare baseline (a markup of 1031%). 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 |
|---|---|---|
| Centura Employee Plan | $543 | 223% |
| Blue Cross Blue Shield | $737 | 302% |
| Kansas Health | $1,080 | 443% |
| Aetna | $1,080 - $2,699 | 443% |
| Humana | $1,080 | 443% |
| Medicare (plans) | $1,080 | 443% |
| UnitedHealthcare | $1,080 - $2,814 | 443% |
| Multiplan | $3,036 - $3,138 | 1245% |
| Health Partners Of Kansas | $3,171 | 1301% |
| Wppa | $3,205 | 1315% |
Consumer Guidance & Cost Commentary
For this MRI of the brain (no contrast) at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's cash price is $1,350, which is significantly lower than the state average of $3,374. While commercial insurance plans like Aetna and UnitedHealthcare have negotiated rates ranging from $1,080 to $2,814, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking a prompt-pay discount. It is important to note that Medicare allows a payment of only $243.77 for this service, highlighting the substantial markup found in commercial billing structures. Since the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should explicitly ask about self-pay or prompt-pay discounts before scheduling to ensure they are not billed the full negotiated rate.
Patients should be aware that commercial insurance rates can sometimes be higher than cash prices due to administrative costs and contract dynamics, even when the facility is in-network. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, where the provider bills you for the difference between their full charge and what your insurance pays. However, the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities. To avoid surprise costs, always request a full itemized bill before paying, as summary bills can hide unbundled codes or services not rendered. If you believe you are being overcharged, dispute the bill in writing with the billing supervisor rather than accepting the summary invoice or signing away your rights via consent waivers.