CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Mercy Hospital Lebanon

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,827
Cash Discount Price: $3,316
vs. Medicare Baseline: 10.74x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Hospital Lebanon is $3,827. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,316. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.74x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.

Cash / Self-Pay

$3,316

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,827

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: $3,316 (930%)

Insurance Median: $3,827 (1074%)

Cash: $3,316 (930% of Medicare)

Ins. Median: $3,827 (1074% 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 1074% of the Medicare baseline (a markup of 974%). 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
Medicaid / KanCare	$183 - $730	51%
Medicare (plans)	$327 - $346	92%
Aetna	$340 - $2,224	95%
Blue Cross Blue Shield	$340 - $2,519	95%
Champva [20065]	$340	95%
Cherokee Nation Health Serv Contracted [320066]	$340	95%
Cigna	$340 - $3,775	95%
Cross Timbers Hospice [20098]	$340	95%
Dept Of Veteran Affairs Contracted [320106]	$340	95%
Elara Caring Aspire Hospice [20433]	$340	95%
Globalhealth Contracted [320145]	$340	95%
Halo Hcr Inc Hospice Contracted [320432]	$340	95%
Halo Hcr Inc Hospice [20432]	$340	95%
Humana	$340 - $4,337	95%
Kindful Hospice Contracted [320434]	$340	95%
Kindful Hospice [20434]	$340	95%
Mercy Hospice Okc [20252]	$340	95%
Mercy Mgd Behavioral Health Contracted [320259]	$340	95%
Pace Of The Ozarks Contracted [320518]	$340	95%
Provider Partners Health Plans Contracted [320450]	$340	95%
Qual Choice Contracted [320325]	$340	95%
Tricare	$340	95%
UnitedHealthcare	$340 - $4,847	95%
Healthscope Contracted [320182]	$433	121%
Centivo Contracted [320505]	$572	160%
Ambetter / Centene	$730	205%
Home State Health Plan Contracted [320187]	$730	205%
Novasys Contracted [320285]	$730	205%
Medica Contracted [320239]	$1,203	338%
Medica [20239]	$1,203	338%
Administrative Payor Contracted [320005]	$2,296	644%
Healthlink Contracted [320179]	$3,316 - $4,337	930%
Preferred Health Plan Contracted [320522]	$3,316	930%
90 Degree Benefits Contracted [320436]	$3,826	1073%
Mercy Benefit Admin Contracted [320251]	$3,826 - $4,082	1073%
Show-Me Health Administrators Contracted [320483]	$3,826	1073%
United Medical Resources Contracted [320454]	$3,826 - $4,082	1073%
Aither Health Contracted [320449]	$4,082	1145%
Auxiant Contracted [320462]	$4,082	1145%
Benefit Management Contracted [320052]	$4,082	1145%
Ebms Contracted [320493]	$4,082	1145%
Edison Health Solutions Contracted [320502]	$4,082	1145%
Evolutions Health Care Contracted [320124]	$4,082	1145%
First Health Contracted [320128]	$4,082	1145%
Health Systems Inc Contracted [320174]	$4,082	1145%
Imagine 360 Contracted [320494]	$4,082	1145%
Insurance System Inc Contracted [320465]	$4,082	1145%
Point C Contracted [320238]	$4,082 - $4,847	1145%
Point C [20238]	$4,082	1145%
Reflect Health Contracted [320492]	$4,082	1145%
Workers Comp [20426]	$4,082 - $4,337	1145%
Yuzu Health Contracted [320521]	$4,082	1145%
American Healthcare Alliance Contracted [320020]	$4,337	1217%
Usa Managed Care Org Contracted [320429]	$4,490	1260%
Multiplan Contracted [320270]	$4,847	1360%
Private Health Care Systems Contracted [320320]	$4,847	1360%

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 $3,316.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Lebanon is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
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.