CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Mercy Hospital Joplin
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $1,522
- Cash Discount Price: $3,297
- vs. Medicare Baseline: 4.27x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Hospital Joplin is $1,522. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,297. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.27x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$3,297
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,522
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$356.43
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $3,297 (925%)
Insurance Median: $1,522 (427%)
Cash: $3,297 (925% of Medicare)
Ins. Median: $1,522 (427% of 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 427% of the Medicare baseline (a markup of 327%). 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.
Input your details and click calculate to compare out-of-pocket costs.
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 | $176 - $3,698 | 49% |
| Indian Health Service Contracted [320198] | $176 - $3,297 | 49% |
| Aetna | $183 - $368 | 51% |
| Humana | $183 - $1,522 | 51% |
| Medicaid / KanCare | $183 - $578 | 51% |
| Champva [20065] | $318 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $318 | 89% |
| Cigna | $318 - $1,766 | 89% |
| Cross Timbers Hospice [20098] | $318 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $318 | 89% |
| Elara Caring Aspire Hospice [20433] | $318 | 89% |
| Globalhealth Contracted [320145] | $318 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $318 | 89% |
| Halo Hcr Inc Hospice [20432] | $318 | 89% |
| Kindful Hospice Contracted [320434] | $318 | 89% |
| Kindful Hospice [20434] | $318 | 89% |
| Medicare (plans) | $318 - $334 | 89% |
| Mercy Hospice Okc [20252] | $318 | 89% |
| Mercy Mgd Behavioral Health Contracted [320259] | $318 | 89% |
| Pace Of The Ozarks Contracted [320518] | $318 | 89% |
| Provider Partners Health Plans Contracted [320450] | $318 | 89% |
| Qual Choice Contracted [320325] | $318 | 89% |
| Tricare | $318 | 89% |
| UnitedHealthcare | $318 - $828 | 89% |
| Centivo Contracted [320505] | $324 | 91% |
| Healthscope Contracted [320182] | $405 | 114% |
| Ambetter / Centene | $492 | 138% |
| Home State Health Plan Contracted [320187] | $492 | 138% |
| Novasys Contracted [320285] | $492 | 138% |
| Providrs Care Network Contracted [320484] | $661 | 185% |
| United Medical Resources Contracted [320454] | $828 - $1,335 | 232% |
| Health Choice Contracted [320166] | $893 | 251% |
| Medica Contracted [320239] | $1,101 | 309% |
| Healthlink Contracted [320179] | $1,520 - $3,297 | 426% |
| Point C Contracted [320238] | $1,776 - $4,058 | 498% |
| 90 Degree Benefits Contracted [320436] | $1,943 | 545% |
| Mercy Benefit Admin Contracted [320251] | $1,943 - $2,892 | 545% |
| Show-Me Health Administrators Contracted [320483] | $1,943 - $2,041 | 545% |
| Benefit Management Contracted [320052] | $2,181 | 612% |
| Health Systems Inc Contracted [320174] | $2,181 | 612% |
| Insurance System Inc Contracted [320465] | $2,181 | 612% |
| Administrative Payor Contracted [320005] | $2,283 | 641% |
| Aither Health Contracted [320449] | $2,892 | 811% |
| Auxiant Contracted [320462] | $2,892 - $3,297 | 811% |
| Ebms Contracted [320493] | $2,892 | 811% |
| Edison Health Solutions Contracted [320502] | $2,892 | 811% |
| Imagine 360 Contracted [320494] | $2,892 | 811% |
| Reflect Health Contracted [320492] | $2,892 | 811% |
| Yuzu Health Contracted [320521] | $2,892 | 811% |
| Preferred Health Plan Contracted [320522] | $3,297 | 925% |
| First Health Contracted [320128] | $3,455 | 969% |
| American Healthcare Alliance Contracted [320020] | $3,551 | 996% |
| Multiplan Contracted [320270] | $3,906 | 1096% |
| Private Health Care Systems Contracted [320320] | $3,906 | 1096% |
| Usable Contracted [320409] | $3,906 | 1096% |
| Point C [20238] | $4,058 | 1139% |
| Workers Comp [20426] | $4,058 - $5,073 | 1139% |
| Usa Managed Care Org Contracted [320429] | $4,464 | 1252% |
| Ppo Plus Contracted [320310] | $4,566 | 1281% |