MRI, brain (with and without contrast)
Facility: Susan B Allen Memorial Hospital
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $554
- Cash Discount Price: $1,915
- vs. Medicare Baseline: 1.55x 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.
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 |
|---|---|---|
| UnitedHealthcare | $350 | 98% |
| Providrs Care | $757 | 212% |
Consumer Guidance & Cost Commentary
For the MRI of the brain at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $1,915, which is significantly lower than the facility's negotiated rates of $554. This price transparency data indicates that for patients with high-deductible plans or those without insurance, paying out-of-pocket directly may result in substantial savings compared to using commercial insurance, where the negotiated rate often exceeds the cash price. While the facility is a voluntary non-profit acute care hospital, patients should verify their specific plan details, as commercial insurance contracts can sometimes result in higher out-of-pocket costs than self-pay options.
The Medicare benchmark for this procedure is $356.43, serving as a baseline for fair pricing; the facility's cash rate is approximately 5.4 times the Medicare amount, reflecting standard commercial pricing structures. It is important to note that while the data shows specific payer ranges for UnitedHealthcare and Providrs Care, these negotiated amounts do not represent the lowest possible cost for all patients. Consumers are encouraged to request an itemized bill before payment to ensure no unbundled codes or services not rendered are included, and to inquire about prompt-pay discounts that could further reduce the final balance.