Out-of-Pocket Costs
Does Insurance or Medicare Cover an MRI? What Is and Isn't Covered
How deductibles, coinsurance, prior authorization and Medicare Part B decide what you pay for an MRI, and when a scan is not covered at all.
Insured MRI Out-of-Pocket Calculator
Estimate your share of an in-network MRI from the allowed amount, your coinsurance and any copay.
Health plans split an MRI bill between you and the insurer using three tools: the deductible, coinsurance and copays. This calculator handles the coinsurance and copay part. Enter the amount your plan has allowed for the scan (the in-network negotiated rate, not the sticker price), the coinsurance percentage on your plan, and any flat copay.
Deductible note: if you have not met your deductible, you pay the allowed amount up to the remaining deductible first. To include it, subtract the deductible you still owe from the allowed amount, enter the remainder here, and then add the deductible portion to the result yourself.
Worked example (illustrative only): The plan allows $1,200 for the scan, you have already met your deductible, and your coinsurance is 20 percent with no copay. Your share is 1,200 x 0.20 = $240 and the plan pays $960. If you had $500 of deductible left, you would enter $700 as the amount: 700 x 0.20 = $140, plus the $500 deductible, for $640 in total.
This tool ignores your annual out-of-pocket maximum, which caps your cost for covered in-network care, and it does not model out-of-network rules or services your plan denies. Call your insurer for the exact allowed amount using the billing code (CPT) for your scan before you rely on any estimate.
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