Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
MRI GUIDANCE NDL PLMT RS&I [OR]
Low
$71
Average
$2.2k
Median
$1.2k
High
$33.5k
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
32 hospitals; the 90th percentile is 4.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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63 hospital rates
iThe hospitals that file a Medical Mutual rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 1 | $33.5k | $33.5k | — | — | 1–10 | $33.5k – $33.5k |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $394 | $394 | — | — | — | $394 – $394 |
| 3 | Children's Hospital Medical Center Mason, OH percent of total billed charges · inpatientfrom % of charges | 2 | $1.2k | $1.2k | $253 | 21% | — | $950 – $1.5k |
| 4 | Children's Hospital Medical Center Mason, OH percent of total billed charges · outpatientfrom % of charges | 2 | $1.2k | $1.2k | $253 | 21% | — | $950 – $1.5k |
| 5 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 6 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 7 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $933 | $933 | — | — | — | $933 – $933 |
| 8 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $632 | $632 | — | — | — | $632 – $632 |
| 9 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 3 | $1.5k | $1.5k | $1.1k | 72% | — | $428 – $2.7k |
| 10 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 3 | $1.2k | $1.3k | $540 | 42% | — | $672 – $2.1k |
| 11 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 12 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 13 | Mishawaka Medical Center Mishawaka, IN facility · percent of total billed charges · bothfrom % of charges | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 14 | Mount Carmel East Reynoldsburg, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 15 | Mount Carmel Grove City Grove City, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 16 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 1 | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 18 | St Mary Medical Center Langhorne, PA professional · fee schedule · inpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 19 | St Mary Medical Center Langhorne, PA professional · fee schedule · outpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 20 | St Peters Hospital Albany, NY facility · other · both | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 21 | St. Joseph Health System, LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 22 | St. Joseph Health System, LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 23 | TRINITY HOSPITAL HOLDING COMPANY St.Clairsville, OH fee schedule · outpatient | 1 | $920 | $920 | $46 | 5% | — | $874 – $965 |
| 24 | The Toledo Hospital Maumee, OH facility · other · outpatient | 1 | $794 | $794 | — | — | — | $794 – $794 |
| 25 | University Hospitals Health System Chardon, OH facility · case rate · outpatient | 3 | $1.3k | $1.3k | $102 | 8% | — | $1.1k – $1.4k |
← Payers reporting CPT 77021 · Snapshot 20261112T181611Z-3fa9fb76