MRI Brain Cost
Mri brain stem w/o & w/dye
$462Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an MRI brain costs up to about $462 in total at a hospital outpatient department, counting both the physician and the facility. Outside a hospital, one global fee of about $317 covers the whole test, and a ZIP code adjusts every figure to your area.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
National Medicare physician rate (2026)
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Get the rate for your ZIP
CMS adjusts this CPT by locality. A five-digit ZIP is enough: no account, no insurance card.
What MRI brain costs at hospitals near you
Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 90001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. For this code the office and hospital physician lines differ by $211.76.
How CMS prices CPT 70553
Work is about 23% of the office total RVU; practice expense is about 75%. Localities with a high PE GPCI move this code more when practice expense is a large share.
Office vs hospital for this code
Office (non-facility) physician rate: $316.97. Hospital (facility) physician rate: $105.21.
Medicare patients typically owe 20% of the allowed amount after the Part B deductible, about $63 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.
Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.
MRI Brain cost by state
2026 Medicare non-hospital rate for CPT 70553, averaged across each state's localities. Open a state for its locality table and full cost breakdown.
What Is MRI Brain?
This is the most complete brain MRI protocol: the scanner first takes a full set of images without dye, then repeats key sequences after an IV gadolinium injection, letting the radiologist compare the two. It is the standard workup for suspected brain tumors, multiple sclerosis, pituitary problems, and infection. Plan for 45 to 60 minutes in the scanner with an IV in your arm, making it the longest and most expensive of the three brain MRI codes.
What Affects the Cost
- –As the combined protocol, 70553 carries the highest base price of the brain MRI family, before facility markup differences.
- –Hospital imaging departments charge far more than independent centers for this long scan.
- –The gadolinium dose is a separate supply charge on top of the imaging codes.
- –Longer scanner time means claustrophobia or movement problems are more likely to require sedation or a rescan, each adding cost.
- –Follow-up MRIs to track a finding over time repeat the full cost at each interval, so the surveillance schedule matters as much as the single-scan price.
How It Is Billed
CPT 70553 bundles the without-contrast and with-contrast sequences into one code; you should not see 70551 and 70552 billed together for the same session, which would be improper unbundling. Contrast material bills separately as a supply, and hospitals split technical and professional fees while freestanding centers usually quote globally. If this scan is tracking a known lesion, each surveillance study is a fresh, fully billed claim.
Insurance & Coverage Notes
Commercial prior authorization is essentially universal for this study, and because it is the priciest brain MRI protocol, radiology benefit managers sometimes approve a lesser study instead; the ordering physician can request a peer-to-peer review to justify the full protocol. High-deductible plan members often pay the entire allowed amount out of pocket, making the center-versus-hospital price gap their single biggest savings opportunity. Medicare applies standard Part B coinsurance without authorization requirements.
Questions to Ask Before Booking
- 1.Was the full without-and-with-contrast protocol authorized, or only a plain MRI?
- 2.What is your global price for this study at a freestanding center?
- 3.How many follow-up scans is my condition likely to need, and at what interval?
- 4.Are the contrast agent and radiologist reading included in the quoted price?
- 5.If my insurer pushes back, will my doctor do a peer-to-peer review to defend this protocol?
MRI Brain (CPT 70553): questions
Under 2026 Medicare rates, an MRI brain costs up to about $462 in total at a hospital outpatient department, counting both the physician and the facility. Outside a hospital, one global fee of about $317 covers the whole test, and a ZIP code adjusts every figure to your area.
Outside a hospital, one global fee pays for the equipment, the staff and the doctor's reading, so the office or imaging center rate for CPT 70553 is $316.97. In a hospital the physician bills only the reading, about $105.21, and the hospital is paid for the rest on its own claim.
This is the most complete brain MRI protocol: the scanner first takes a full set of images without dye, then repeats key sequences after an IV gadolinium injection, letting the radiologist compare the two. It is the standard workup for suspected brain tumors, multiple sclerosis, pituitary problems, and infection. Plan for 45 to 60 minutes in the scanner with an IV in your arm, making it the longest and most expensive of the three brain MRI codes. CMS bills it as “Mri brain stem w/o & w/dye.”
It depends on the setting. At an independent imaging center, lab or office, $316.97 is Medicare's full national rate, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $105.21) and the hospital is paid separately, which takes the total to about $462. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.
For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.