CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Howard County Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,079
Cash Discount Price: $4,627
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Howard County Medical Center is $1,079. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,627. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.03x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$4,627

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,079

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: $4,627 (1298%)

Insurance Median: $1,079 (303%)

Cash: $4,627 (1298% of Medicare)

Ins. Median: $1,079 (303% 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 303% of the Medicare baseline (a markup of 203%). 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
Medica Standard Premier	$100 - $298	28%
Aetna	$104 - $4,396	29%
Medica Elevate	$196 - $584	55%
Midland'S Choice	$206 - $614	58%
Humana	$247	69%
Blue Cross Blue Shield	$291 - $4,396	82%
Great Plains	$291 - $2,637	82%
Medica Chi	$291 - $2,637	82%
Tricare	$291 - $3,470	82%
UnitedHealthcare	$291 - $4,442	82%
Nebraska Total Care - Wellcare	$300	84%
Molina Healthcare	$306 - $2,314	86%
Oscar Health	$509	143%
Ambetter / Centene	$582	163%
Beshp	$582	163%
Nebraska Total Care	$2,314	649%
Medica Chi Aco	$4,211	1181%
Medica Choice National	$4,211	1181%
Medica Ifb Aco	$4,442	1246%
Medica Ifb Open Access	$4,442	1246%

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 $4,627.
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 Howard County Medical Center 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.