CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sanford Canton-Inwood Medical Center - Cah

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,459
Cash Discount Price: $2,650
vs. Medicare Baseline: 10.09x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sanford Canton-Inwood Medical Center - Cah is $2,459. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,650. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.09x the Medicare baseline. Located in 440 North Hiawatha Drive, Canton, SD.

Cash / Self-Pay

$2,650

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,459

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $2,650 (1087%)

Insurance Median: $2,459 (1009%)

Cash: $2,650 (1087% of Medicare)

Ins. Median: $2,459 (1009% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1009% of the Medicare baseline (a markup of 909%). 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
Sanford Health Plan Align	$1,133	465%
Ucare	$1,216 - $2,910	499%
Wellmark	$1,216 - $2,881	499%
Aetna	$1,229 - $2,878	504%
Health Partners	$1,229 - $2,484	504%
Medicare (plans)	$1,229	504%
UnitedHealthcare	$1,229 - $2,766	504%
Primewest	$1,252	514%
Sanford Health Plan	$1,815 - $2,434	745%
Security Health Plan	$1,822	747%
Medica	$2,732 - $2,921	1121%
First Choice Health Network	$2,981	1223%
Healthez	$2,981	1223%
Multiplan	$2,981	1223%

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 $2,650.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Canton-Inwood Medical Center - Cah is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.