MRI Out-of-Pocket Estimator
Get a fast view of MRI cost sharing. Enter the billed price and your coinsurance to see the allowed amount, what applies to your deductible, and what you likely owe versus what the plan pays—capped by the remaining out-of-pocket maximum.
Benefits vary by plan. Use your insurer's Explanation of Benefits for final amounts; this tool provides an estimate only.
Examples
- $3,500 billed charge, 20% coinsurance, defaults for deductible, allowance, and OOP max ⇒ Patient owes: $420.00 USD • Plan pays: $1,680.00 USD • Allowed amount considered: $2,100.00 USD.
- $5,000 billed charge, 30% coinsurance, $1,000 deductible left, 50% allowed, $1,200 OOP remaining ⇒ Patient owes: $1,200.00 USD • Plan pays: $1,300.00 USD • Allowed amount considered: $2,500.00 USD.
FAQ
What if my plan allows a different percentage?
Update the allowed amount percentage to mirror your network contract or EOB for a closer estimate.
Does this include facility fees or radiologist bills?
No. Add those billed amounts separately and rerun the calculation if they are billed outside the main MRI charge.
How does hitting the out-of-pocket max change the result?
If the calculation exceeds your remaining OOP max, the patient responsibility is capped there and the plan pays the balance of the allowed amount.
Additional Information
- Result unit: USD for patient responsibility and plan payment based on allowed amount calculations.
- Defaults assume 60% of billed charges are allowed and $0 deductible remaining, capped by $5,000 of headroom to the OOP maximum.
- Coinsurance applies only after the allowed amount exceeds any remaining deductible.