There are more than 10,000 hospitals and outpatient clinics that offer MRI imaging procedure scans. This blog post provides you an insider view on how to choose the right facility to get the high-quality MRI scan reading that does not ruin your budget. Your first step to get an MRI scan is to get hands on a doctor referral that will provide the imaging facility with the information which scan to conduct.
MRI is an abbreviation for Magnetic Resonance Imaging, MRI scanner is a device that uses high field magnetic field and strong radio waves to take images of your brain, internal structure or other body parts. In some situations CT scans might be a preferred option to make medical images especially if you need to create image of a soft tissue or internal organs that have high water content such as lung scans. In most other cases an MRI is a better option as it has no side effects and does not expose your body to radiation, which at high exposure can lead to cancer.
Usually when a doctor prescribes an MRI he write down the CPT code (e.g. 72158 - MRI Lumbar Spine w/wo Contrast) for the exact procedure that you need. She will also mark whether this is an MRI with contrast, MRI without contrast or MRI with or without contrast or any special procedure such as an MRA, so the facility can follow her instructions and make the correct imaging.
Do not despair, in a perfect world we would advise you to find a personal doctor that can guide you through your next steps of meeting your health needs, but in this case that you are about to run a 10K and just need to do a quick MRI scan to see if your knee hurts because of strain or something more major, you can still use one of the telemedicine offices, to ask for an MRI referrals.
If you are above certain age, or you are at risk of having an allergic reaction to the contrast medium, the doctor will also prescribe you to get the CBC/BUN ratio.
It will help the medical team find out how is your liver and kidneys working and if they can handle processing the contrast medium, which will be injected to your bloodstream right before the MRI imaging is done. Generally this is a quick test, that requires a taking a small blood sample and results are back within 2-3 days. Once you have that, you are ready to proceed with your imaging scan.
Usually the doctor will have a preferred facility where he can right away fax your scan, or will give you a list of 20-30 facilities to choose from. Please be wary of any scans done directly on clinic premises or in hospitals. Unless doctors operate on cash basis, they do not have any incentive other than their best intentions to send you to a facility that is affordable.
Hospitals & outpatient clinics are competing for this kind of business as it can be very lucrative and often they will buy the latest machines (that can offer state-of-art care but also can cost 10x the usual amount), integrate their systems with the doctor office computers, so doctors can get the results quickly or even just wine & dine them.
Unfortunately while all of this things are handy to the doctor, they lead to higher running costs and margins which are reflected in sometimes horrendous bills. And even $25,000 MRI imaging bill is not unheard of.
If the doctor has directly faxed the RX order to your facility of choice, they will call you from the facility to schedule your exam. Please note, even though a doctor might have put a specific name of facility on the doctor order, it does not mean that you are required to go there. You can take your referral to any facility of choice.
You can either search on Google for a phrase like MRI near me, go to yelp to see which one are top imaging centers and call them to inquiry about the price.
In general hospitals will tend to cost 2x-3x more, sometime even 10x hasn't been unheard of in terms of the cost for an MRI. They do frequently have best in state imaging machines, but this might not be always the case and sometimes due to lack of availability they might still do your scan at an older model.
Generally Hospitals are the most expensive nationwide and you can look anywhere from $2,000 - $20,000 for a single MRI scan. And unfortunately there are not too few horror stories of patients getting months later billing scans that make them go bankrupt.
So please proceed carefully and ensure that you either have fully insurance coverage, met your yearly deductible or if you are using an PPO insurance, both your referring doctor, the hospital imaging center and the radiologist are in network. If not you can be charged the full list price for any one of these services which, can cost 10x-20x the actual price.
MRI machine strength is measured in Teslas, usually it goes from 0.3T (open MRIs or old machines to 1.5T Closed machine to state of art 3T or even latest 7T machines. The prices for each vary considerably:
If you are at risk of cancer, or anything life threatening, then the doctor will guide you to pick the best-in class machine and it does not make as much sense to focus on the cost.
If you are looking a a musculoskeletal issue, then the machine quality is improtant but not as necessary. Anything 1.5T or above will do just fine. For Knees, Spines, Shoulders and neck you might be even ok with 0.3T imaging scans. But take into consideration that in some cases you will need to get a second scan due to lower quality.
In general, whenever you go to an outpatient clinic that has good rating and good equipment you already do yourself a great service and made 30%-60% just by this single decision.
What you want to think of next is if you are on a high-deductible plan, you want to check your yearly deductible and if you have or are likely to hit it. The challenge with insurance companies is they are eager to prove the value of being insured and one of the ways they do it they will ask you to pay the full list price out of pocket before your deductible insurance applies.
So what will be counter intuitive is if you asked the outpatient facility about the cash price, this might be even lower then your high-deductible quote or your copay. It's simply a reflection on the cost of processing billing with insurance, insurance denied bills & unpaid bills. Facilities prefer to give you the best price. Note, in some clinics if you mention that you have a particular insurance the facility might be unable to offer you this cash prices as they are contractually obligated to follow insurance guidelines.
So the long story short, if you know your deductible & cash price, if you are close to meeting it, then you want to continue using your insurance, otherwise you are very likely to save a lot of money going with cash route.
They look better on paper as most of the times they don't have such a high deductible, But in many cases there is actually a lot of situations, where the insurance companies will deny you the imaging procedure unless it's life-threatening. in these cases you want to take the doctor referral or get one and take it to a facility of your choice.
These are one of the best insurance plans in country, that being said the facilities still face a risk of loosing too much money on frequent imaging procedures, so what they sometimes do is offer you a date that's 1-3 months in advance to limit the # of patients who decide to pursue this option. In that case you want to still consider your other alternatives.
Medicare & Medical are the biggest medical purchasers in the country, so they have the best negotiation rates and can get $2,000-$20,000 MRIs at large hospitals for the minimum price (varies by machine but starts at $500).
If you are approved for an imaging then please follow this option, you will be just asked to do a 20% co-pay. The referring doctor face a huge fines if they overprescribe imaging, so many times you might be denied this service, if a doctor is close to his limit. In those cases you want to explore other options.
This is the best route with the most options, the only downside is that you don't get to use your insurance, but in most cases you are actually getting the best rate. If you decide to pursue this option, you want to compare at least 5-10 imaging clinics in your area to find the best rate.
Confirm for each facility that the fee covers the imaging scan + radiologist reading fee and then most facilities will also include a cost of making a CD, although some charge $20-$30 extra for this as this is not necessary, but most patients prefer it.
In terms of cash prices these are the lowest we have on our site, even insured patients choose these options as the prices are often better then their co-pays and there is no waiting time.
In general larger agglomerations & more populous states will have more imaging outpatient locations and therefore the laws of demand & supply will drive down the prices. We have seen such trends happening especially in the Los Angeles area & Miami, but this trend is also starting to pick-up in Chicago, New York and other key agglomerations.
Find out the average prices for most frequent imaging procedures:
|CPT Code||MRI procedure||Price||Direct Pay Price||Average (Estimated) Total|
|70552||MRI Brain w/ Contrast||$847||$1,100||$1,692|
|70553||MRI Brain w/o & w/ Contrast||$1,027||$1,335||$2,054|
|70551||MRI Brain w/o Contrast||$664||$863||$1,328|
|72149||MRI Lumbar Spine w/ Contrast||$846||$1,100||$1,692|
|72158||MRI Lumbar Spine w/o & w/ Contrast||$1,033||$1,342||$2,065|
|72148||MRI Lumbar Spine w/o Contrast||$664||$863||$1,328|
|72142||MRI Spine Cervical w/ Contrast||$1,960||$2,547||$3,919|
|72156||MRI Spine Cervical w/o & w Contrast||$1,033||$1,342||$2,065|
|72141||MRI Spine Cervical w/o Contrast||$664||$863||$1,328|
|74182||MRI Abd w/ Contrast||$846||$1,100||$1,692|
|74183||MRI Abd w/o & w/ Contrast||$1,033||$1,342||$2,065|
|74181||MRI Abd w/o Contrast||$664||$863||$1,328|