CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Cox Medical Centers

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,088
Cash Discount Price: $790
vs. Medicare Baseline: 4.46x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Cox Medical Centers is $1,088. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $790. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.46x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$790

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,088

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $790 (324%)

Insurance Median: $1,088 (446%)

Cash: $790 (324% of Medicare)

Ins. Median: $1,088 (446% of 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 446% of the Medicare baseline (a markup of 346%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cox Healthplans	$238	98%
Health Net Federal Services	$238	98%
Humana	$238	98%
Medrisk Llc	$238	98%
UnitedHealthcare	$238 - $2,250	98%
Blue Cross Blue Shield	$241 - $2,121	99%
Allwell	$245	101%
Devoted	$254	104%
Provider Partners Health Plan	$254	104%
Parkcrest Dental Group	$1,002	411%
Coastal Energy Corporation	$1,012	415%
Heart Of America Beverage Company	$1,032	423%
Loren Cook	$1,052	432%
Springfieldgreene Co Library	$1,073	440%
Src Holdings Corporation	$1,082	444%
Ozark Anesthesia Assoc. Inc	$1,095	449%
Missouri Affiliated School Consortium (Masc)	$1,125	462%
Justice Furniture And Bedding Co	$1,129	463%
The Durham Company	$1,129	463%
Ozark County	$1,137	466%
Ozarks Cocacola	$1,148	471%
Flora Farms	$1,169	480%
Advanced Concrete Technology	$1,182	485%
Bjc Health Solutions	$3,133	1285%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $790.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cox Medical Centers is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.