Questions to ask before an MRI
The questions that turn a vague scan into a number you can plan around: the cash price for your CPT code, what it includes, who reads the images and what the hospital's own price file says.
Updated . Country: United States
An MRI is one of the easier medical bills to price before you have it, because the hospital's file and its price estimate line are both required to exist. The hard part is asking the right questions. This page is the list to take to the phone call.
Before you call
- Know your CPT code. Brain without contrast is 70551, lumbar spine 72148, shoulder 73221, knee 73721. If your doctor ordered contrast, use the with-contrast code from the same family.
- Know how you will pay: cash (self-pay), in-network insurance or out-of-network insurance. The answer changes the questions.
- Have your doctor's order or prescription in front of you, with the body part and side (left or right).
The questions
1. "What is your cash price for CPT number?" Given without a code, an estimate desk cannot price your scan. Give the code and ask for the cash discount price — the hospital's own published number for a self-pay patient.
2. "Does that price include the radiologist's reading?" The scan and the reading are often billed separately. A quote that covers only the facility fee will still be followed by a radiologist bill. Ask for the total that includes both, and get it in writing.
3. "What does the price include — contrast, technologist, facility?" Ask what is in the number and what is not. Contrast, for example, is a separate row in a hospital's file and is only needed if your doctor ordered it.
4. "Do you discount for self-pay?" Cash prices are set to win patients who are not billing an insurer, so a published cash discount price can beat the list price by a wide margin. Ask for it directly.
5. "If I bill insurance, what will my part be?" In-network, ask for the negotiated rate and what your deductible and coinsurance leave you with. Out-of-network, ask whether the hospital and the radiologist are in your plan at all — an out-of-network scan can cost several times more.
6. "What does your published machine-readable file say for this code?" Under the federal price transparency rule the hospital's standard charges are public. On this site, the hospital page shows the cash prices we parsed from its own file. Compare the phone quote with the file.
7. "Is this the same price if my doctor changes the plan — contrast, another body part?" Planned scans can change. Ask for the price of the alternative code too, so an add-on does not surprise you.
What to do with the answers
Get the total in writing before you schedule — an email from the estimate office is enough. Keep the CPT code and the written quote with your appointment confirmation. When the bill arrives, check it against the quote line by line, and if a fee is new, ask the hospital to explain it against its published file.
A hospital with a parsed file on this site shows its MRI cash prices per scan type, read from the hospital's own file. Until a file is parsed, the page honestly reads "price undisclosed" — and the checklist above is still the fastest way to a real number: the hospital's file is public whether we have parsed it or not.