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
HC MRI BREAST UNI W W/O CONTRAST
Low
$282
Average
$732
Median
$355
High
$2.5k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 6.5× 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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36 hospital rates
iThe hospitals that file a Wellmark 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 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $336 | $336 | — | — | — | $336 – $336 |
| 2 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 3 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $356 | $356 | — | — | — | $356 – $356 |
| 4 | Covenant Medical Center Inc Waterloo, IA facility · other · both | 1 | $332 | $332 | — | — | — | $332 – $332 |
| 5 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 6 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $973 | $973 | $45 | 5% | — | $928 – $1.0k |
| 7 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 8 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $356 | $356 | — | — | — | $356 – $356 |
| 9 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · both | 1 | $372 | $372 | — | — | — | $372 – $372 |
| 10 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 11 | MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 12 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 13 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · outpatient | 1 | $397 | $397 | — | — | — | $397 – $397 |
| 14 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient | 1 | $372 | $372 | — | — | — | $372 – $372 |
| 15 | Mount Carmel East Reynoldsburg, OH facility · fee schedule · both | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 16 | Mount Carmel Grove City Grove City, OH facility · fee schedule · both | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 17 | Mount Carmel St Ann's Lewis Center, OH facility · fee schedule · both | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 18 | Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient | 1 | $355 | $355 | — | — | — | $355 – $355 |
| 19 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 20 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 21 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 22 | Saint Francis Hospital and Medical Center Hartford, CT facility · fee schedule · both | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 23 | Samaritan Hospital Troy, NY facility · fee schedule · both | 3 | $895 | $964 | $110 | 11% | — | $878 – $1.1k |
| 24 | St Josephs Hospital Health Center Syracuse, NY facility · other · both | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 25 | St Josephs Hospital Health Center Syracuse, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $778 | $778 | — | — | — | $778 – $778 |
← Payers reporting HCPCS C8905 · Snapshot 20261111T120946Z-9134e7f7