Comparing MRI Costs: In-Network vs. Out-of-Network Providers

The cost of an MRI is influenced by the part of the body being scanned, the use of contrast agents, and whether it is conducted by an in-network or out-of-network provider. Comparing MRI costs and knowing what to expect can help you save time, as well as money, and get high-resolution, detailed images for timely diagnosis of possible conditions. At Manhattan MRI, you can look forward to top-quality scanning services and insurance coverage that helps you focus on your health needs as quickly as possible.

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Unexplained pain or internal injury that cannot be diagnosed with physical examination or other tests may require a magnetic resonance imaging (MRI) scan. It is one of the most powerful and effective diagnostic tests that produces detailed pictures of areas inside the body to help determine conditions so you can get timely treatment.

However, MRIs can be expensive. While health insurance typically covers authorized MRIs, you may encounter out-of-pocket costs such as deductibles, copay, or coinsurance. If you have health insurance, the type of insurance and your plan requirements will affect how much you will contribute to the cost of your medical imaging.

Insurance coverage for MRI depends on the specific insurance plan and policy. In many cases, MRIs are covered by insurance when deemed medically necessary. This usually includes situations when an MRI is required for diagnostic purposes, to plan treatment or surgery, or to monitor the progress of a known medical condition.

How Much Does an MRI Scan Cost?

On average, MRIs in the US can cost $400 to $12,000. The actual price you pay depends on your body area being examined, the location or type of facility, medications used, the cost of medical staff, and administrative costs.

At Manhattan MRI, the cost for a single body part MRI is $450. For a comprehensive whole-body MRI, the price is $1,999. We work with all major insurance plans, including United Healthcare, Blue Cross, Blue Shield, Cigna, Aetna, GHI, 1199, and Empire Plan. Please note that HMO plans, Medicaid, and Medicare are not accepted. Payment options include credit card and cash, but checks are not accepted.

When searching for an imaging center, it is essential to know about your provider network and the choices you have. MRI costs can also vary significantly between in-network and out-of-network providers.

• In-network providers – These providers have negotiated special rates with your insurance company and must charge the contracted rate. You will see these savings listed as a discount on the claims and explanation of benefits statements. You are responsible for paying the difference between the total charge and your plan’s approval amount. The in-network providers are less expensive.You must call and schedule an appointment to get a prior appointment to save time and money. Specific imaging tests should be pre-approved as described in your health insurance benefits information or package.
• Out-of-network providers – These providers are not part of your insurance network and may charge higher rates. An out-of-network rate is set by the imaging center or hospital, not the insurance company, resulting in higher and often unexpected fees. You may have to pay the entire cost of the MRI or a large portion.To lower the costs of your imaging test, try and understand what type of MRI you need, how much your insurance provider is willing to cover before out-of-pocket expenses, and what you need to do if you are uninsured.Review your insurance policy or contact the insurance provider directly to understand the specifics of your insurance coverage for out-of-network MRIs. They can provide information on your out-of-network benefits, reimbursement rates, and other relevant details.

Comparing MRI costs of in-network vs. out-of-network providers can help you avoid unnecessary expenses and get reliable imaging services as well as the best value and care for your budget.

Does Health Insurance Cover the Full Cost of an MRI?

Imaging tests like MRIs are generally covered in some part by health insurance. You can call your insurance provider to check if your MRI is covered under your health plan with the coverage amount. You may still have to pay out-of-counter expenses, but health plans may cover 100% of your MRI costs, depending on your employer or circumstances.

Several plans cover authorized MRIs at no charge. It is also important to check if your health plan requires a referral for an MRI or if preauthorization is necessary.

How Much Does an MRI Scan Cost Without Insurance?

MRI scan costs vary greatly as many factors can impact the cost. However, you can expect to pay anything from $400 to $12,000 for an MRI, depending on the type of MRI you require, and the body part being examined.

If you do not have health insurance, you will have to pay the total cost of the MRI. After an MRI, you may receive two bills, one from the facility and the other from the radiologist. Billing also depends on the healthcare professional and the facility you have chosen for the test.

In case you live in a rural area where there are fewer MRI facilities available to you, it can increase the costs. The region, state, and city where you live will determine the facilities you have to choose from. You will find lower-cost options in a city with many facilities and providers.

Navigating healthcare expenses can be overwhelming, especially when you do not have health insurance or opt to pay yourself. Understanding the cost of an MRI becomes critical so you can search for the best facility, compare prices, and openly discuss potential discounts or payment plans with service providers.

What Are the Factors That Can Affect MRI Cost?

Several factors can impact the overall expenses of your diagnostic exam.

They include:

• Type of health insurance – The primary factor that can affect the cost of an MRI is insurance coverage. Depending on your insurance coverage, how much you will pay for your test can vary from a copay to a percentage of the bill.
• In-network versus out-of-network providers – Healthcare providers in your network must charge the contracted rate negotiated with the insurance company. This rate is much lower than the out-of-network or out-of-pocket costs you would end up paying if you did not have insurance.
• Type of scan – An open MRI costs less than a traditional or closed MRI scan. Also, an MRI with contrast costs more.
• Use of contrast – Contrast is a special dye used to enhance the MRI image. Your physician may order an MRI with contrast to get a better look at the abnormalities in your body. Adding dye can increase the cost of your MRI by a few hundred dollars.
• Part of the body being examined – MRI prices can also vary depending on the body part that has to be scanned. A brain scan may cost more than a knee scan as it requires a more detailed analysis from a radiologist.
• Your location – Just as the cost of living varies from one location to another, the cost of MRI varies from city to city. Your city, state, or area of the country can affect MRI costs.
• Place of service – Having your scan at a freestanding MRI usually costs less than a scan at a hospital because freestanding centers are less expensive to run.
• Use of medication – If you are claustrophobic and need a sedative, it can increase medication cost. The type of sedation required, such as oral, IV conscious sedation, or general anesthesia, can affect the costs.
• Radiologist reading – There may be a charge for the radiologist to review and interpret your results.

Insurance coverage can significantly lower these costs, depending on deductibles and copays.

Our Most Popular Services

• Full Body MRI
• Brain MRI
• Breast MRI
• Knee MRI
• Cardiovascular MRI
• Prostate MRI
• Pregnancy MRI
• Abdominal MRI

View All Our MRI Services

What to Do if You Cannot Afford an MRI?

If you cannot afford an MRI, there are several options you can consider:

• Reach out to the facility and discuss your financial situation. Hospitals and imaging centers have financial assistance programs, payment plans, or discounts available for people who cannot afford the full cost upfront. Explain your situation and enquire about options that can help to make the MRI more affordable or even free.
• Some communities have organizations or programs that provide financial assistance or low-cost imaging services. Check out local community health centers, free clinics, or charitable organizations that may offer resources or financial aid for diagnostic imaging, or they may be able to connect you with subsidized MRI options.
• Universities, medical centers, or research institutes often conduct clinical trials or research studies that involve diagnostic imaging. These studies may offer free or low-cost MRI scans as a part of their research protocols. Check with your local medical research centers or online databases to see if you can be a part of a study.
• Depending on your specific medication condition, you can also go for alternative, more affordable imaging options. Ask your healthcare provider if X-rays or ultrasounds can provide essential information instead of an MRI.

Share your financial concerns with your healthcare provider, and they may be able to explore other diagnostic options, suggest lower-cost facilities, or advocate on your behalf to help you.

Check with your healthcare provider’s office about the following financing options, as they can help reduce the upfront costs:

1. Assistance programs
2. Discounts
3. Medical payments

Remember, affordability is a significant factor, but it is crucial to prioritize your health. Do not let MRI costs keep you from getting the medical care you need. Work closely with your healthcare provider and explore the available options to find the most appropriate and affordable solution for your specific situation.

Manhattan MRI makes your diagnostic testing a comfortable and convenient experience. Call us today or book your MRI scan online and start your journey towards a healthier life. Our specialists focus on your imaging needs, provide the best scanning services, and help you make informed decisions about your healthcare expenses.