MRI prices are really complicated: Different facilities, different machines, different parts of the body. Yikes.
Different facilities — from the hospital, to the radiology center, to the doctor’s office — charge vastly different prices for MRIs. For example, the cash price of a lumbar spine (lower back) MRI at a hospital can reach more than $6,000, while the cash price of the same test at an independent radiology facility can be as low as $300 or so.
For our sampling of cash or self-pay prices of lumbar spine MRIs in the San Francisco area, click here. For our sampling of cash or self-pay prices in the New York area, click here. For our sampling of cash or self-pay prices in Houston, click here.
For our sampling of cash or self-pay prices of lumbar spine MRIs in the Los Angeles area, click here.
Using our search tool, and on these results lists, you can see that several providers will undercut the Medicare price, which is the closest thing in the market to a fixed or benchmark price.
Different Prices at Different Facilities
There are also private radiology facilities that offer exceptionally low costs, such as $295 at RPN of California, a low-cost MRI services network with headquarters in Ontario, Calif. (Read more about RPN on our blog.) RPN has also opened facilities in Phoenix and Tempe, Ariz. (Update: RPN is now closed.–Editor.)
Some hospitals and radiology clinics post prices online. At Dartmouth-Hitchcock Medical Center in New Hampshire and Vermont, the price for a spine MRI is listed at $3,693. At Metro Imaging in St. Louis, the “average charge” for an MRI is listed at $998. At QuakerBridge Radiology in New Jersey, the self-pay price is $465. At Denville Diagnostics in Denville, N.J., the self-pay price for an MRI without contrast is $475.
Finding An Affordable MRI
So how can you find a low-cost or affordable MRI if you’re price-sensitive?
Hospitals often charge more and ascribe those higher charges to overhead, according to Martha Bebinger, a reporter who specializes in health costs at WBUR radio in Boston. She described her discovery about the cost of an MRI in a radio interview here.
Ms. Bebinger was charged nearly $8,000 on the bill, but the insurance company paid $1,650. This is the “negotiated price,” so called because it’s negotiated by the provider and the insurance company.
Do you get more if you pay more for an MRI? The answer is complicated: maybe, but not necessarily.
There can be differences in image quality from different machines, though the most expensive ones are not necessarily the best. In addition, the MRI is only as good as the radiologist interpreting the images.
Some places that charge more (like hospitals) may have more experienced, expert radiologists. If your doctor orders an MRI, ask him or her to recommend some facilities with the best radiologists — that way you’ll get the most from your MRI.
You can also ask your provider if a lower-cost MRI provider is acceptable. In general, hospitals charge more than self-standing radiology practices.
Insurance Plans and MRIs
Depending on your provider, some insurance plans will cover the full cost of an MRI, but only at a participating provider. Some plans will leave you in charge of the co-pay (if applicable).
If an insurance provider “participates” in the network your insurance coverage uses, the price can be a negotiated price, which means it’s negotiated by the payer and provider to offer a discount. For other insurance plans, you may be responsible for a percentage of the sticker price, or a percentage of the negotiated price, or for a fixed co-payment amount, or a full amount until you’ve met your deductible.
The takeaway: Questions to ask
As we always say, know before you go. Questions to ask:
- Is this covered by insurance? (if applicable)
- How much will this cost? How much will this cost me?
- Do you have a sliding scale based on income?
- Is there a fee for reading the MRI? How much is it?
- Are there other fees or charges?
- What else do I need to know?
Next: Part 2 of “How much does an MRI cost?” What kinds of MRI are there, and what additional charges might there be?