MRI costs: What you’ll pay with and without insurance

In the United States, healthcare pricing isn’t often straightforward. To fix this issue, the Centers for Medicare and Medicaid Services (CMS) introduced a new hospital price transparency rule that went into effect on January 1, 2021. The ruling requires hospitals to publish their pricing in a consumer-friendly format. Despite this ruling, finding and understanding a hospital’s pricing information is still challenging. 

Magnetic resonance imaging, or MRI, is a common imaging technique that helps diagnose various health conditions. MRIs can develop detailed images of your organs and structures using magnets and radio waves. It falls under the category of other diagnostic imaging, such as CT scans and X-rays.

An MRI involves a magnetic field that scans your head, neck, back, chest, spine, upper extremities (arms and hands), abdomen, or lower extremities ( legs and feet) to see if there are any abnormalities.

In the United States, the cost of this procedure can range from $375 to $2,850, with the national average cost of an MRI being $1,325. There’s no set cost of an MRI, as the prices vary based on several factors.

How much does an MRI cost without insurance?

There’s a wide price range for an MRI scan because many factors can impact the cost. According to Michael Yudelevich, MD, an independent patient advocate at My Personal Health Advocate in New York City, an MRI can range from $400 to $12,000. 

You may have to pay the full price if you don’t have health insurance. 

How much does an MRI cost with insurance?

As mentioned previously, there’s no exact price for an MRI, but if you have insurance, you may be able to save some money on this medical procedure. But to ensure that your insurance provider will help cover the costs, you may need to meet your deductible first. 

A deductible is what you pay for covered health services before your insurance provider starts to pay. For example, if you have a $2,000 deductible, you must pay that out of pocket.

Once you’ve paid your deductible, you’ll only be responsible for paying coinsurance or a copay for medical services. If you have a high-deductible health plan (HDHP), you may pay more out-of-pocket expenses, leaving you to cover most or the complete cost of your MRI if you haven’t yet met your deductible for the year.

If you’re unsure of the details of your health plan, reach out to your insurance provider.

Do Medicaid and Medicare cover MRI costs?

Both Medicaid and Medicare provide partial or complete coverage for MRI costs. “Medicaid, which is state medical insurance for those with low income, covers all medical services, including MRIs, without cost to patients,” says Virgie Bright Ellington, MD, a medical billing expert based in New York City and author of What Your Doctor Wants You Know to Crush Medical Debt.

It is essential to mention that Medicaid coverage can vary by state, as they can establish their own eligibility rules and requirements. With this in mind, consult your Medicaid advisor to discuss how much an MRI will cost. 

Regarding Medicare, Part B covers diagnostic non-laboratory tests, including MRI procedures. After meeting your deductible, you will need to pay 20% of the Medicare-approved amount. 

The amount you’ll pay for an MRI will depend on whether you receive care in an inpatient or outpatient facility. Medicare recipients spend an average of $59 for MRIs at ambulatory surgical centers and $94 at hospital outpatient departments.

“The only time I see Medicaid and Medicare not covering an MRI is because they believe that it is not required,” says Adria Goldman Gross, a medical bill advocate and CEO and president of MedWise Insurance Advocacy in Monroe, New York. “Many times, they recommend other avenues before they will agree to pay for an MRI.”

Factors that affect the cost of an MRI

The primary factors that can affect the cost of an MRI include insurance coverage, type of facility (inpatient or outpatient), location of MRI (area of the body), and geographic location.

In addition to these factors, Dr. Ellington shares that radio-opaque contrast agents and additional technician fees can impact MRI costs. Radio-opaque contrast agents are drugs used to diagnose certain medical conditions. They contain gadolinium, an element to help increase the effect of the MRI’s magnetic field.

Insurance coverage

If you have insurance coverage, your out-of-pocket expenses for an MRI will vary depending on what your health plan or policy covers. Your insurance deductibles, coinsurance, and copays all can contribute to the costs of an MRI.

Another factor that impacts MRI costs with insurance is whether or not you’ll receive the medical service with or without an in-network provider. With insurance coverage, your health plan will have a provider network of in-network providers and hospitals they contract with to provide care to you and other members. You can contact your health insurance company for assistance in choosing a provider in your network. 

However, in some cases, whether insurance covers an MRI is the insurance company’s decision. They have the right to determine whether your MRI is medically necessary, and if they don’t, they can refuse to cover your costs.

When this occurs, you may need to request a “letter of medical necessity” from your healthcare provider that they can send to your insurance company as part of their certification or utilization review process. 

After submitting documentation, your insurance provider will review your requested medical services to determine if they’ll help cover your MRI’s partial or total costs or if you’ll be responsible for out-of-pocket costs.

“Prior authorizations may be necessary both with Medicare and Medicaid, which are usually submitted by the ordering physician prior to the diagnostic imaging study,” Dr. Yudelevich says. “Each insurance plan will have specific requirements for these authorizations.”

Type of MRI

Several types of MRIs are administered for various medical reasons and on certain parts of the body. Below are examples of the different types of MRIs a radiologist performs:

• Abdominal 
• Cervical
• Cranial
• Chest
• Heart
• Lumbar
• Pelvic
• MRA (MR Angiography)
• MRV (MR Venography)
  

The type of MRI you need will affect the overall cost of the medical service.“When it comes to a brain MRI with contrast, Medicare’s highest rate is $366.14 using procedure code 70552,” Gross says. After reviewing procedure codes for all available MRIs, Gross found brain MRIs to be the most expensive.

Open MRI vs. closed MRI

Also, the type of MRI machine plays a crucial role in what you’ll pay. There are two main types of MRI machines: closed-bore and open-bore.

A closed-bore or simply closed MRI machine has a 60-centimeter ring of magnets—a “bore”—where you’d lie during the procedure to have your images taken. Because of its size and the fact that it’s closed on all sides, it’s common for people to feel a bit cramped or claustrophobic, but it does deliver more detailed images.

An open-bore or open MRI machine provides a more comfortable experience for people who are claustrophobic, as it has a larger space between the magnets than a closed-bore machine. However, the distance between the patient and the magnets lowers the imaging quality.

In addition, open-bore MRIs tend to cost less than closed-bore MRIs because closed-bore MRIs tend to be a more complex type of machine and have pricier maintenance needs. 

Type of hospital or outpatient facility

One factor that affects MRI costs is whether it is performed in an outpatient or inpatient setting. Inpatient care facilities typically cost more than outpatient care facilities because of the additional facility costs on top of the procedure costs and physician fees. “A knee MRI, for example, can cost as little as $268 at an independent outpatient facility and go up to $3,227 at an outpatient facility affiliated with a hospital or medical center,” Dr. Ellington says.

Compared among inpatient facilities, nonprofit and government hospitals charged more for brain MRIs than for-profit hospitals, according to a research article published in the journal JAMA Network Open. The article reveals that the health system’s characteristics account for 36% of the variation in prices for brain scans. Also, higher-priced facilities tend to be in more affluent areas, have fewer Medicare patients, and employ physicians in their MRI departments. These findings suggest that non-profit and public hospitals tend to have more bargaining power when negotiating with insurance providers.

However, it is important to mention that if an outpatient facility partners with a hospital, the cost of medical care may rise significantly. “​Radiology and other outpatient departments affiliated with hospitals are always the most expensive settings to get medical services,” Dr. Ellington adds.

Geographic location

Where you live also significantly affects the cost of an MRI. “Government and private insurance pay rates for medical services, including MRIs, vary according to region,” Dr. Ellington says.

According to research on commercially insured patients, moving to a region with 10% higher spending on health care leads to a 4.2% increase in your spending on individual medical care. The study concluded that 42% of the variation in healthcare spending was based on location.

With this in mind, MRI costs can fluctuate based on where you seek the procedure.

Here’s a chart of the average price range of MRIs in some of the biggest cities in the country:

Source: New Choice Health

Whether you’ll need medication

Getting an MRI, especially one involving a close-bore machine, can make some people claustrophobic and anxious. To help calm patients, your radiologist may prescribe medication before administering an MRI. This will add to the overall cost of this medical procedure.

“​Physicians requesting MRIs for their patients will usually provide a prescription for an anti-anxiety medication for those who are anxious in small spaces,” Dr. Ellington says.

If sedation is necessary, an anesthetist or anesthesiologist will administer the medication before the procedure and charge additional money for you to be under regional or general anesthesia, according to Gross.

Below are some examples of antianxiety and sedative medications given to MRI patients:

• Xanax (alprazolam)
• Ativan (lorazepam)
• Valium (diazepam)
• Versed (midazolam)
• Precedex (dexmedetomidine)
• Ketalar (ketamine)
• Diprivan (propofol)
• Sevoflurane 
• Remimazolam

Speak with your healthcare provider facilitating your MRI imaging to explore treatments for anxiety or claustrophobia before your procedure. 

Bottom line

MRI prices can range from a few hundred to several thousand dollars, depending on several factors. The costs of an MRI range due to insurance coverage, type of facility, type of MRI, location, and medications prescribed for the procedure. To help lower the costs of your MRI, take time to understand what type of MRI you need, how much your insurance provider is willing to cover before you have to pay out-of-pocket expenses, and what you need to do if you’re uninsured.