MRI with contrast

Package

MRI with contrast

MRI with contrast is a noninvasive imaging test that uses a strong magnetic field and radio waves to create detailed pictures of organs and tissues, with an injected contrast dye used to highlight specific structures such as blood vessels, tumors, or areas of inflammation. The dye is given through an IV before or during the scan and helps the radiologist identify abnormalities that may not be visible on a standard MRI. The scan typically takes 30 to 60 minutes, during which you will need to remain still inside a tube-shaped scanner. Most patients tolerate the contrast well, and any reactions are monitored by your care team.

You'd pay up to

$1,226 /

Case Rate

The estimated total cost of care without any insurance coverage or discounts.

Location

Insurance Plan

$1,226

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest

$576

Highest

$2,681

Cash price

up to $1,226

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the MRI with contrast Standard Service Package (SSP RA004). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code	Code Type	Description
HCPCS 75561	Professional Fee	Cardiac MRI with Pre and Post Contrast Imaging
HCPCS A9575	Facility Fee	Intramuscular injection of gadoterate meglumine, 0.1ml
HCPCS 75561	Facility Fee	Cardiac MRI with Pre and Post Contrast Imaging
HCPCS 75565	Facility Fee	Cardiac Velocity Flow Mapping by MRI
Revenue Code 255	Facility Fee	Pharmacy (Also see 063X, an extension of 250X) - Drugs incident to radiology

Disclaimer

Hawaii Health Systems Corporation is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to

$1,226 /

Case Rate

The estimated total cost of care without any insurance coverage or discounts.

Location

Insurance Plan

Disclaimer

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Service	MRI with contrast
Service Codes	HCPCS 75561, HCPCS A9575, HCPCS 75565, Revenue Code 255
Insurance	I'm not using insurance
Location	Hilo Benioff Medical Center Main