MRI, brain (with and without contrast)
Facility: Wamego Health Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $261
- Cash Discount Price: $1,763
- vs. Medicare Baseline: 0.73x 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 - $368 | 25% |
| Aetna | $93 - $383 | 26% |
| Medicaid / KanCare | $93 - $383 | 26% |
| Providrs Care | $146 - $452 | 41% |
| Tricare | $549 | 154% |
| Blue Cross Blue Shield | $726 - $764 | 204% |
Consumer Guidance & Cost Commentary
For the MRI of the brain (with and without contrast) at Wamego Health Center in Wamego, KS, the cash median price is $1,763.00, which is significantly lower than the facility's gross charge of $4,407.00. While commercial insurance plans like UnitedHealthcare, Aetna, and Medicaid/KanCare negotiate rates ranging from $89 to $383, these amounts often exceed the cash price for patients with high-deductible plans. Because commercial negotiated rates include administrative overhead and contract markups, paying cash upfront can sometimes result in a lower out-of-pocket cost. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing the standard insurance billing cycle.
It is important to understand that the facility's negotiated rates do not represent the lowest possible price, as commercial contracts often include multi-layered administrative structures that inflate the baseline cost. To ensure you are not overpaying, you should request a full itemized CPT-coded bill before agreeing to any payment plan, as summary bills often obscure individual charges or include unbundled codes for services not rendered. Additionally, while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, it is crucial to dispute any unexpected out-of-network charges in writing with certified mail rather than accepting verbal assurances. By comparing the facility's rates against the Medicare benchmark of $356.43 and seeking a detailed audit of your statement, you can identify errors and negotiate a fair price that aligns with the true cost of care.