CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Mercy Hospital Lincoln

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,843
Cash Discount Price: $2,800
vs. Medicare Baseline: 7.98x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Hospital Lincoln is $2,843. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,800. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.98x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.

Cash / Self-Pay

$2,800

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,843

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: $2,800 (786%)

Insurance Median: $2,843 (798%)

Cash: $2,800 (786% of Medicare)

Ins. Median: $2,843 (798% 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 798% of the Medicare baseline (a markup of 698%). 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	$280 - $1,977	79%
UnitedHealthcare	$449 - $2,843	126%
Blue Cross Blue Shield	$469 - $3,317	132%
Workers Comp [20426]	$560 - $3,446	157%
Aetna	$646 - $2,822	181%
Tricare	$922	259%
Medicare (plans)	$930 - $4,308	261%
Provider Partners Health Plans Contracted [320450]	$1,008	283%
American Health Advantage Of Mo Mcr [10473]	$1,014	284%
Cherokee Nation Health Serv Contracted [320066]	$1,014	284%
Cross Timbers Hospice [20098]	$1,014	284%
Dept Of Veteran Affairs Contracted [320106]	$1,014	284%
Elara Caring Aspire Hospice Contracted [320433]	$1,014	284%
Elara Caring Aspire Hospice [20433]	$1,014	284%
Globalhealth Contracted [320145]	$1,014	284%
Halo Hcr Inc Hospice Contracted [320432]	$1,014	284%
Halo Hcr Inc Hospice [20432]	$1,014	284%
Humana	$1,014 - $3,877	284%
Indian Health Service Contracted [320198]	$1,014	284%
Kindful Hospice Contracted [320434]	$1,014	284%
Kindful Hospice [20434]	$1,014	284%
Mercy Hospice Okc [20252]	$1,014	284%
Pace Of The Ozarks Contracted [320518]	$1,014	284%
Qual Choice Contracted [320325]	$1,014	284%
Cigna	$1,081 - $3,576	303%
Centivo Contracted [320505]	$1,564	439%
Medica Contracted [320239]	$1,809	508%
Ambetter / Centene	$1,977	555%
Home State Health Plan Contracted [320187]	$1,977	555%
Novasys Contracted [320285]	$1,977	555%
Hope Trust Contracted [320488]	$2,132	598%
Health Choices Contracted [320448]	$2,585	725%
Health Choices [20448]	$2,585	725%
Medical Associates Health Contracted [320444]	$2,585	725%
First Health Contracted [320128]	$2,822	792%
United Medical Resources Contracted [320454]	$2,843	798%
Multiplan Contracted [320270]	$3,231	906%
Healthlink Contracted [320179]	$3,489 - $3,834	979%
Aither Health Contracted [320449]	$3,662	1027%
Aither Health [20449]	$3,662	1027%
Auxiant Contracted [320462]	$3,662	1027%
Ebms Contracted [320493]	$3,662	1027%
Edison Health Solutions Contracted [320502]	$3,662	1027%
Federal Medical Center Contracted [320127]	$3,662	1027%
Imagine 360 Contracted [320494]	$3,662	1027%
Insurance System Inc Contracted [320465]	$3,662	1027%
Mercy Benefit Admin Contracted [320251]	$3,662	1027%
Mercy Benefit Admin [20251]	$3,662	1027%
Point C Contracted [320238]	$3,662	1027%
Preferred Health Plan Contracted [320522]	$3,662	1027%
Reflect Health Contracted [320492]	$3,662	1027%
Show-Me Health Administrators Contracted [320483]	$3,662	1027%
Tri State Healthcare Coalition Contracted [320379]	$3,662	1027%
Yuzu Health Contracted [320521]	$3,662	1027%

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 $2,800.
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 Lincoln 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.