MRI, brain (with and without contrast)
Facility: Regional Medical Center
Billing Code: 70553 (CPT)
- CPT Billing Code: 70553
- Insurance Median: $870
- Cash Discount Price: $4,195
- vs. Medicare Baseline: 2.44x 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 244% of the Medicare baseline (a markup of 144%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 244% |
Consumer Guidance & Cost Commentary
For an MRI of the brain (with and without contrast) at the Regional Medical Center in Manchester, IA, the cash median price is $4,195. This facility, a government-owned Critical Access Hospital, lists a gross charge of $5,244, while the negotiated rate paid by the single in-network payer, Medical Associates Health Plan - Tri, is $870. The Medicare benchmark for this service is $356.43, which serves as the objective baseline for evaluating pricing markups.
To ensure you are receiving the best possible rate, remember that cash-pay options can sometimes be more cost-effective than insurance for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. However, in this specific case, the $870 negotiated rate is significantly lower than the cash price of $4,195, making the insurance option the clear financial choice. Always verify your specific plan's deductible status before scheduling and request a detailed itemized bill to rule out errors or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.