Magnetic resonance imaging (MRI) is a painless, noninvasive scan that uses a magnet, radio waves, and a computer to create detailed images of organs and tissues. MRIs are a powerful tool used to diagnose and monitor medical conditions throughout the body.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293fdb1dbe-377c-4596-886c-2411d7dfe8c1 The cost of an MRI scan can vary depending on your health insurance plan , geographic location, provider, and other factors. In general, total costs for an MRI can range from roughly $700 to more than $5,400, but out-of-pocket costs for someone with insurance are usually considerably less.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292bf3d9de-ef4e-41e2-a17a-5bf9046e07cfe60dc2a1-f33c-4a05-9b50-8e3e8e597629ae20046c-0b57-45b1-bccc-e8e35a18d05f
Are MRIs Covered by Insurance? Insurance Coverage Your coverage depends on the individual policy you have. Most insurance plans require prior authorization for an MRI, and you may need to get the scan at an in-network facility. But MRIs are typically covered when they’re ordered by a doctor and considered medically necessary, including for the following reasons:e60dc2a1-f33c-4a05-9b50-8e3e8e59762918033534-659b-4419-827e-18ba2e01870e To diagnose or evaluate a specific medical condition To monitor the progress of a known medical condition To provide detailed imaging information prior to surgery, such as joint replacement or the removal of a tumor To evaluate acute injuries after an accident or if you’re experiencing severe pain To manage chronic conditions, particularly those impacting the brain, spine, or joints
Is There Usually a Large Copay? Copay Expenses The amount you’re expected to chip in will depend on your individual plan. What you are expected to pay may come in the form of coinsurance rather than a copay. Both terms refer to how much a patient will owe for healthcare costs, but a copayment is a set dollar amount, while coinsurance is a percentage of the total cost.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bf528b31-35f9-4ef7-a3f5-13aeb9902297 A common coinsurance arrangement is for the insurance company to pay 80 percent of the costs, while you’re responsible for 20 percent. To determine your exact cost, check your insurance plan for details. If you need clarification about your coverage, call your insurance company directly. When you’re scheduling a doctor-recommended MRI, ask the facility where it will be performed for a cost estimate and any copay or coinsurance responsibilities.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e872b51-5893-49aa-8654-9edac5fbc981
Does the Cost Depend on What Body Part Is Being Examined? Costs for Different Procedures Costs may vary somewhat depending on the body part being examined, but there are bigger factors that drive the cost variation, including your geographic location, health insurance plan, and where you get the scan. Comparing prices at different imaging centers will help you find the most affordable rate. Your doctor’s office should have trusted imaging centers in your area that they can recommend, and you can also use healthcare cost comparison websites to find the cheapest option.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290a61c690-ccbe-4cbc-b51f-581f8c4a2867
Is an Open MRI More Expensive? Open MRIs It’s possible that an open MRI could cost less than one performed with a closed machine. The main difference between open and closed MRI machines is their design. Open machines have a large opening instead of a tube-like structure. The machinery and maintenance costs for open MRIs are lower, so that may translate into lower costs for the consumer.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e3a0cf4c-a681-4eae-b31f-e399d08e5bf7 Open MRI machines are a better option for those who have claustrophobia , since there’s open space on two sides. On the other hand, the images they capture may not be as clear.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cf476bc2-8306-4d26-a8d6-631d963bbb8d
Cost: Hospital vs. Private Provider Hospital vs. Private Provider MRIs are performed in hospitals and private radiology centers. Some urgent care centers also offer MRI services. Because hospitals are larger and more expensive to operate, MRIs performed there are typically pricier than those performed at a freestanding radiology center.e60dc2a1-f33c-4a05-9b50-8e3e8e59762960888af8-5280-4350-a944-31c5398c4a1b There can also be variations in costs from one hospital to another. One study found that brain MRIs are cheaper at for-profit hospitals than nonprofit ones, and rural hospitals are more expensive than urban ones.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac49fcb4-2dc3-4939-8ad0-33512f7b1458 If you have Medicare Part B, 80 percent of the cost of an MRI will be covered once you meet the deductible. If you get the test at a hospital as an outpatient, you will also pay the hospital a copayment. If you get the test from a physician’s practice, clinic, or freestanding radiology center outside of a hospital, make sure the facility is accredited. Medicare won’t pay for the test if it isn’t.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bef96d57-ef20-4600-aa10-fd5f6f54c74c
What Should I Do if My Insurance Won’t Cover an MRI? When Insurance Doesn’t Cover It Your insurance may deny coverage for these reasons:e60dc2a1-f33c-4a05-9b50-8e3e8e5976296748e307-6eb5-4156-882a-28a8e327792c It’s not considered medically necessary. You’re not eligible under your specific health plan. The MRI is considered experimental for your condition. The claim was filed too late. If you receive a denial letter, it needs to include detailed information on your rights to file an appeal , including the specific reason the claim was denied and deadlines to file an appeal. If the appeals process is not successful, consider having an MRI at a freestanding MRI center, which is typically less expensive than a scan performed at a hospital. The American College of Radiology’s search tool allows you to look for accredited imaging facilities near you.
The Takeaway Magnetic resonance imaging (MRI) is a medical procedure that scans the inside of the body to capture detailed images of organs and tissues. These pictures help doctors diagnose and monitor a variety of health conditions. The total cost for an MRI ranges from roughly $700 to over $5,400, but out-of-pocket costs for people with insurance are considerably less. Factors such as your location and insurance provider will affect how much you have to pay. Health insurance usually covers MRIs that have been deemed medically necessary or are needed for emergency situations. You may need to obtain prior authorization or go to an in-network facility for a non-emergency.
Resources We Trust Mayo Clinic: MRI Cleveland Clinic: Brain MRI Centers for Disease Control and Prevention: Facts About Imaging Procedures MD Anderson Cancer Center: CT Scan vs. MRI: What’s the Difference? HealthCare.gov: Appealing a Health Plan Decision
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