March 27, 2023
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March 27, 2023

What To Expect When Paying for Your MRI Cost Out of Pocket

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What To Expect When Paying for Your MRI Cost Out of Pocket

Key takeaways:

  • An MRI is a valuable tool for evaluating your health and screening for disease.
  • Costs vary for MRIs based on factors like location, type of scan, and whether you have insurance.
  • Hidden fees some providers charge may result in a surprise bill after you’ve paid your share.
  • Ezra offers comprehensive MRIs that may decrease your MRI costs out-of-pocket.

The price transparency movement seeks to make all healthcare costs and fees public and easily accessible. Understanding how much medical procedures cost can empower you to get the care you need and comparison shop for better value.

When researching how much an MRI costs out of pocket, you’ll notice there is a very wide range of prices. Whether you have health insurance coverage is often the biggest factor that determines what you’ll pay.

However, even with insurance there is variance. Some policies may leave you owing nothing out of pocket. Others, such as high-deductible plans, may require you to pay thousands of dollars upfront for MRI procedures.

Average Price Range for MRIs

According to Imaging Technology News, you and/or your insurance company may pay between $400 and $10,500 for an MRI.

A few factors cause this price disparity, such as where you live, the scan provider or scan facility, the type of scan, and the body part being scanned.

Besides the cost of the scan, there are other out-of-pocket costs related to primary care visits and specialist referrals. For example, in some cases, you may get a bill from the radiology service weeks after your scan.

How Much Does an MRI Cost Out of Pocket With Insurance?

If you have health insurance, the out-of-pocket cost is your share of covered healthcare costs. Some out-of-pocket costs include:

  • Insurance premium: The amount you pay each month for your insurance plan. If you are insured, a portion of this may be taken from your paycheck each time you’re paid.
  • Deductible: The amount you have to pay out-of-pocket before your insurance kicks in.
  • Copay: The fixed amount your insurance company requires you to pay for a covered procedure or treatment. This is usually due at the time you receive the treatment
  • Coinsurance: A percentage of your total cost (after meeting the deductible) you have to pay for covered expenses.

The specific amount you’ll pay for an MRI varies based on your policy. If you have insurance, you can find out what your MRI out-of-pocket costs are by visiting your insurance provider’s website or calling your insurance company’s customer service

To avoid paying more of your MRI costs out of pocket when you have insurance, be sure you are following all the rules of coverage.

Health insurance companies may deny your claim, refuse to pay, reduce coverage, or charge penalties for medical procedures that are not pre-approved or are out of network. Most times, insurance will only cover a specialist if your primary care provider (PCP) orders a referral.

How Much Does an MRI Cost if You Have Medicare?

According to Medicare.gov, if approved by your doctor, an MRI may cost as little as $59 at a standalone outpatient facility or $95 at a hospital outpatient facility.

The caveat is that you may have to first meet your deductible and you may incur additional costs. Because of these variances, Medicare advises that you talk to your plan provider about costs.

MRI Costs if You’re Uninsured or Prefer to Self-Pay

couple talking while drinking coffee

If you are self-employed, a small business owner, between jobs, a recent college graduate, or have aged out of a parent’s health insurance coverage, you might find yourself without health insurance coverage.

During the first months of COVID (February to May 2020), 5.4 million laid-off workers became uninsured. This resulted in the population of uninsured growing 39% larger than any other time in history.

However, you are likely eligible for insurance under the Affordable Care Act. Don’t delay care due to the assumed cost of a scan. It’s easy to figure out what your MRI costs will be ahead of time.

Again, MRI prices vary by location, type of study, and other factors like whether you use an outpatient imaging center or a hospital ER. Some imaging centers bundle their charges, while others send multiple bills.

MRI Average Costs by Location

There’s pricing disparity for routine procedures like MRIs based on your location and body region scanned, though these shouldn’t be much different in theory.

Using New Choice Health, here are a few examples we found for average MRI out-of-pocket costs based on location alone:

  • Atlanta: $550 to $1,400
  • Chicago: $575 to $1,500
  • Miami: $550 to $1,450
  • Los Angeles: $460 to $1,200
  • New York: MRI $625 to $1,600

Cost of an MRI by Type

If you are self-paying, finding out how much an MRI costs is easier than ever. Thanks to new price transparency laws in the United States, providers must list the cost of their procedures on their website and have pricing readily available at facilities.

Here is a sampling of MRI costs in the San Francisco market. Please take note that these price ranges represent current estimates of scan costs that are subject to change.

  • Brain MRI: $4275 to $5500
  • Abdominal MRI: $3549 to $4500
  • Pelvis MRI: $552 to $1671
  • Thoracic spine MRI: $421 to $3586

Other Factors Affecting Out-of-Pocket MRI Costs

You’ll usually pay more for an MRI as an inpatient procedure while admitted to a hospital or while visiting the emergency department than you will if you choose to schedule an MRI at a freestanding imaging center or outpatient facility.

According to data from HFMA, a standard MRI of the head/neck/brain could cost 1.8 times more in the hospital than as an outpatient.

The type of MRI machine may increase the amount you’ll end up paying. However, it’s more difficult to quantify.

Some facilities, like ezra partners, use the latest 3T MRI scanners available without passing the overhead costs to you. Other scan providers may increase their prices to cover the cost of purchasing and operating similar high-quality imaging equipment.

Sometimes, “professional fees,” which include paying for a radiologist to read and interpret your images, are included in the total cost. However, if your case requires an additional set of eyes or special expertise, you may get another bill for consultation fees.

Another cost you might get billed for is the technical/facility charge. This may include medical imaging equipment, facilities, and the technicians who are there to assist you during the procedure and who operate the imaging equipment.

What Does a Comprehensive MRI Cost Out of Pocket?

Considering that an MRI of just the brain can cost as much as $5500 (depending on where you live), you probably think that the cost of a whole body MRI would be unaffordable.

However, an ezra Full Body is a comprehensive scan that includes an MRI of multiple organs at the same time and is currently priced at $1,950. They offer flexible payment options, including monthly payment plans and accept FSA/HSA dollars.

A Full Body includes MRI imaging of the brain, kidneys, adrenal glands, thyroid, bladder, gallbladder, ovaries, uterus, pancreas, spleen, prostate, and liver. A Full Body Plus includes the heart and lungs and is currently priced at $2,350. You don’t need to pay co-pays, co-insurance, high deductibles, or any hidden fees.

Ezra accepts health savings accounts dollars from you FSA and HSA. They also offer monthly payment plans and an annual membership plan that can save you even more.

Get High-Quality Care and Lower Your Costs With ezra

mri cost out of pocket: happy couple hugging

Cost concerns shouldn’t keep you from taking charge of your health.

Ezra’s self-pay pricing and convenient in-house payment plans make it easy for everyone to have access to the same high-quality medical imaging services.

Ezra facilities in San Francisco, Los Angeles, New York, and Greater Miami use cutting-edge 3T MRI machines. The entire scan usually takes around an hour. Results will typically be available in about two weeks after your scan and will be delivered to you via a telehealth visit with an ezra clinician.

Ezra makes getting an MRI a comfortable and convenient experience. Booking your scan is easy, and it’s entirely online. When you arrive for your scan, ezra provides a pair of comfy pajamas and earplugs. In some imaging centers, you can scan while listening to your chosen Spotify playlist.

The best part is that ezra doesn’t require insurance and you don’t need a referral from your primary care provider to schedule a scan.

Ezra offers an optional post-scan video consultation with a licensed ezra Medical Provider to discuss your ezra Report. Their reports are easy to digest enabling you to take better control of your healthcare.