MRI, brain (with and without contrast)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $330
- Cash Discount Price: $230
- vs. Medicare Baseline: 0.93x 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 | $89 - $925 | 25% |
| Medicaid / KanCare | $93 - $383 | 26% |
| Aetna | $93 - $383 | 26% |
| Providrs Care | $146 - $452 | 41% |
| Medicare (plans) | $330 - $337 | 93% |
| Humana | $330 - $334 | 93% |
| Va | $330 | 93% |
| Smarthealth | $462 | 130% |
| Tricare | $549 | 154% |
| Ambetter / Centene | $561 | 157% |
| Blue Cross Blue Shield | $598 - $630 | 168% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Ascension Via Christi Hospital Manhattan, Inc, the facility's cash price of $230.00 is significantly lower than the Medicare benchmark of $356.43, which serves as the objective baseline for true healthcare costs. While the facility's negotiated rates with commercial payers like UnitedHealthcare and Aetna range from $89 to $925, these amounts often exceed the cash price, making self-pay a potentially more cost-effective option for patients with high-deductible plans who have not yet met their coverage thresholds. It is important to note that commercial insurance contracts typically include administrative overheads that inflate the baseline price by 20% to 40%, meaning that the negotiated rates paid by insurers do not necessarily reflect the lowest possible cost for the service.
Patients should proactively contact the hospital before scheduling to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront. Although the facility's median negotiated rate of $330.00 is close to the state average for this procedure, the gross chargemaster price of $575.00 represents the full list price that should be ignored when evaluating actual costs. To ensure you are not overcharged, request a detailed, itemized bill that breaks down every CPT code and unit cost, as summary invoices often obscure errors or unbundled charges. Given that over 80% of hospital bills contain mistakes, verifying the line-by-line details before payment is the most effective way to avoid unnecessary medical debt.