MRI, brain (with and without contrast)
Facility: Salina Regional Health Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $5,092
- Cash Discount Price: $3,960
- vs. Medicare Baseline: 14.29x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1429% of the Medicare baseline (a markup of 1329%). 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.
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 | $551 - $580 | 155% |
| Preferred Phsic | $3,395 | 953% |
| Preferred Healthcare - All Other Plans | $4,583 | 1286% |
| Providers Care (Wppa)-All Plans | $5,092 | 1429% |
| Multiplan (Mpi)-All Plans | $5,092 | 1429% |
| Cigna | $5,092 | 1429% |
| Aetna | $5,092 | 1429% |
Consumer Guidance & Cost Commentary
For the MRI, brain (with and without contrast) procedure at Salina Regional Health Center, the cash median price is $3,960. This cash rate is notably lower than the facility's gross charge of $5,658 and the commercial negotiated rates, which range from $3,395 to $5,800 depending on the insurance carrier. For patients with high-deductible plans, paying the cash price of $3,960 upfront may be more cost-effective than relying on insurance, as some commercial negotiated rates exceed this amount. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the total cost by bypassing administrative billing cycles and claim processing fees.
The Medicare benchmark for this service is $356.43, which serves as the objective baseline for evaluating pricing markups. When compared to this federal rate, the cash price represents a significant markup, while the commercial negotiated rates average 14.3% higher than the Medicare amount. It is important to note that balance billing practices, where providers charge the difference between the full chargemaster and the insurance allowed amount, are generally prohibited for out-of-network providers at in-network facilities under the No Surprises Act. To avoid unexpected costs, consumers should request a full itemized CPT-coded bill rather than accepting a summary invoice, and formally dispute any errors in writing to ensure accurate pricing and prevent double-billing for services not rendered.