CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Lafayette Regional Health Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $3,128
  • Cash Discount Price: $7,447
  • vs. Medicare Baseline: 8.78x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Lafayette Regional Health Center is $3,128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,447. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.78x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$7,447

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,128

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: $7,447 (2089%)
Insurance Median: $3,128 (878%)
Cash: $7,447 (2089% of Medicare)
Ins. Median: $3,128 (878% 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 878% of the Medicare baseline (a markup of 778%). 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
United $207 - $3,351 58%
Healthyblue $211 59%
Medicaid / KanCare $213 60%
Aetna $215 - $6,516 60%
Amerigroup $215 60%
Home State Health Plan $215 60%
Unicare $215 60%
Corvel Corporation $423 - $6,330 119%
Oha Network $427 - $3,723 120%
Ambetter / Centene $1,385 389%
Nhc Advantage $1,415 397%
Universal Healthcare $1,936 543%
Humana $2,517 - $3,202 706%
Blue Cross Blue Shield $2,830 - $7,447 794%
College Park Family Care Center $3,202 898%
Oscar $3,723 1045%
Cigna $4,254 - $5,317 1194%
Wppa Providrs Care Network $5,585 1567%
Multiplan $5,809 1630%
Coventry $5,943 1667%
Coventry Kc Mo $5,943 1667%
Cco, Inc. $6,330 1776%
Focus Healthcare Mgmt, Inc $6,702 1880%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals