CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Mercy Hospital Springfield
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $1,710
- Cash Discount Price: $2,779
- vs. Medicare Baseline: 4.80x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Hospital Springfield is $1,710. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,779. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.80x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$2,779
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,710
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: $2,779 (780%)
Insurance Median: $1,710 (480%)
Cash: $2,779 (780% of Medicare)
Ins. Median: $1,710 (480% 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 480% of the Medicare baseline (a markup of 380%). 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 - $3,267 | 49% |
| Aetna | $183 - $1,306 | 51% |
| Humana | $183 - $2,908 | 51% |
| Medicaid / KanCare | $183 - $587 | 51% |
| Centurion Of Missouri [20459] | $317 | 89% |
| Champva [20065] | $317 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $317 | 89% |
| Cigna | $317 - $1,766 | 89% |
| Cross Timbers Hospice [20098] | $317 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $317 | 89% |
| Elara Caring Aspire Hospice [20433] | $317 | 89% |
| Globalhealth Contracted [320145] | $317 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $317 | 89% |
| Halo Hcr Inc Hospice [20432] | $317 | 89% |
| Indian Health Service Contracted [320198] | $317 | 89% |
| Indian Health Service [20198] | $317 | 89% |
| Kindful Hospice Contracted [320434] | $317 | 89% |
| Kindful Hospice [20434] | $317 | 89% |
| Medicare (plans) | $317 - $333 | 89% |
| Mercy Hospice Okc [20252] | $317 | 89% |
| Mercy Mgd Behavioral Health Contracted [320259] | $317 | 89% |
| Mercy Rehab Hospital Contracted [320260] | $317 | 89% |
| Pace Of The Ozarks Contracted [320518] | $317 | 89% |
| Qual Choice Contracted [320325] | $317 | 89% |
| Tricare | $317 | 89% |
| UnitedHealthcare | $317 - $3,293 | 89% |
| Provider Partners Health Plans Contracted [320450] | $350 | 98% |
| Healthscope Contracted [320182] | $404 | 113% |
| Workers Comp [20426] | $485 - $3,635 | 136% |
| Centivo Contracted [320505] | $534 | 150% |
| Ambetter / Centene | $587 | 165% |
| Home State Health Plan Contracted [320187] | $587 | 165% |
| Novasys Contracted [320285] | $587 | 165% |
| Providrs Care Network Contracted [320484] | $661 | 185% |
| United Medical Resources Contracted [320454] | $828 - $2,224 | 232% |
| Medica Contracted [320239] | $1,203 | 338% |
| Medica [20239] | $1,203 | 338% |
| Healthlink Contracted [320179] | $1,520 - $2,437 | 426% |
| Benefit Management Contracted [320052] | $1,710 | 480% |
| Health Systems Inc Contracted [320174] | $1,710 | 480% |
| Insurance System Inc Contracted [320465] | $1,710 | 480% |
| Administrative Payor Contracted [320005] | $1,924 - $2,138 | 540% |
| Evolutions Health Care Contracted [320124] | $1,924 | 540% |
| Point C Contracted [320238] | $1,924 - $3,207 | 540% |
| Point C [20238] | $1,924 | 540% |
| 90 Degree Benefits Contracted [320436] | $1,943 | 545% |
| Mercy Benefit Admin Contracted [320251] | $1,943 - $2,437 | 545% |
| Show-Me Health Administrators Contracted [320483] | $1,943 - $2,041 | 545% |
| Medical Destinations Contracted [320242] | $2,138 | 600% |
| First Health Contracted [320128] | $2,395 | 672% |
| Aither Health Contracted [320449] | $2,437 | 684% |
| Auxiant Contracted [320462] | $2,437 - $2,779 | 684% |
| Ebms Contracted [320493] | $2,437 | 684% |
| Edison Health Solutions Contracted [320502] | $2,437 | 684% |
| Imagine 360 Contracted [320494] | $2,437 | 684% |
| Reflect Health Contracted [320492] | $2,437 | 684% |
| Yuzu Health Contracted [320521] | $2,437 | 684% |
| Federal Medical Center Contracted [320127] | $2,566 | 720% |
| Multiplan Contracted [320270] | $3,293 | 924% |
| Private Health Care Systems Contracted [320320] | $3,293 | 924% |
| Compcare Of The Ozarks Contracted [320437] | $3,378 | 948% |
| American Healthcare Alliance Contracted [320020] | $3,421 | 960% |
| Qual Choice Contracted [320324] | $3,421 | 960% |
| Municipal Health Plan Contracted [320271] | $3,464 | 972% |
| Usa Managed Care Org Contracted [320429] | $3,763 | 1056% |
| Ppo Plus Contracted [320310] | $3,848 | 1080% |