MRI, brain (no contrast)
Facility: Children'S Mercy South
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $153
- Cash Discount Price: $630
- vs. Medicare Baseline: 0.63x 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.
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 |
|---|---|---|
| UnitedHealthcare | $61 - $1,628 | 25% |
| Medicaid / KanCare | $65 - $153 | 27% |
| Healthy Blue | $65 - $608 | 27% |
| Cigna | $67 - $1,683 | 27% |
| Home State Health | $84 - $535 | 34% |
| Healthlink | $90 - $2,131 | 37% |
| Wppa Providrs Care | $90 - $1,574 | 37% |
| Health Midwest Comprehensive Care | $95 - $1,577 | 39% |
| American Healthcare Alliance | $99 - $2,059 | 41% |
| Quiktrip | $104 - $1,577 | 43% |
| Medica | $118 - $1,412 | 48% |
| Blue Cross Blue Shield | $130 - $1,792 | 53% |
| Multiplan | $130 - $1,841 | 53% |
| Wellfit/Centrus | $132 - $1,574 | 54% |
| Aetna | $133 - $1,647 | 55% |
| Centivo | $136 - $1,574 | 56% |
| Humana | $136 - $1,611 | 56% |
| Orscheln | $137 - $1,574 | 56% |
| Nebraska Furniture Mart | $139 - $1,574 | 57% |
| Mercy Health | $147 - $1,816 | 60% |
| Coxhealth Network | $149 - $1,792 | 61% |
| Coventry Health Care Of Kansas | $168 - $1,792 | 69% |
| National Preferred Provider Network | $178 - $2,180 | 73% |
Consumer Guidance & Cost Commentary
For the MRI, brain (no contrast) procedure at Children's Mercy South in Overland Park, KS, the facility's cash price of $630 is significantly lower than the gross chargemaster rate of $1,312. While the facility's negotiated rates with major payers like UnitedHealthcare and Medicaid/KanCare range from $61 to $1,628, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%.
The facility's pricing is also evaluated against federal benchmarks to ensure transparency. The Medicare reimbursement rate for this service is $243.77, which serves as a baseline for fair pricing; commercial negotiated rates typically average between 200% and 300% of this amount, though fair market value is often considered to be 120% to 150%. In this case, the cash price of $630 represents a markup of approximately 2.6 times the Medicare rate, which is higher than the typical 1.2 to 1.5 ratio seen in fair pricing scenarios. Patients should be cautious of summary bills that obscure individual charges and should request a detailed, itemized statement to identify any unbundled codes or services not rendered, as over 80% of hospital