MRI, brain (no contrast)
Facility: Wamego Health Center
Billing Code: 70551 (CPT)
- CPT Billing Code: 70551
- Insurance Median: $136
- Cash Discount Price: $1,402
- vs. Medicare Baseline: 0.56x 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 $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.
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 | $58 - $234 | 24% |
| Aetna | $60 - $243 | 25% |
| Medicaid / KanCare | $60 - $310 | 25% |
| Providrs Care | $94 - $275 | 39% |
| Tricare | $338 | 139% |
| Blue Cross Blue Shield | $726 - $764 | 298% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (no contrast) at Wamego Health Center in Wamego, KS, the cash median price is $1,402.00, which is significantly lower than the gross charge of $3,505.00. While commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $58 to $310 depending on the specific plan, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the $1,402.00 cash median is lower than the average negotiated rates seen across the six payer plans listed. To secure the best possible price, it is recommended to contact the facility directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare amount for this procedure is $243.77, and the facility's cash rate is approximately 5.7 times higher than this federal baseline, reflecting the typical markup found in commercial pricing. Although the data does not provide specific state or county average comparisons for this exact code, the significant difference between the Medicare rate and the cash price highlights the importance of understanding the true cost basis. Consumers should request an itemized billing audit to ensure no errors exist and verify their deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in unexpected out-of-pocket expenses.