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. But how much does an MRI cost, and what factors affect the price? The answer depends on your insurance plan, where you live, the provider and the type of scan.

What affects the cost of an MRI?

The biggest factors that drive variations in MRI costs include geographic location, your health insurance plan and the facility where you get the scan. According to healthcare cost data, the average price for an MRI in 2022 was almost US$2,000. However, it can run considerably higher depending on the area of the body being scanned and the facility where the scan is conducted. If you have insurance, the out-of-pocket cost is usually considerably less.

Comparing prices at different imaging centres will help you find the most affordable rate. Your doctor's office should have trusted imaging centres in your area that they can recommend, and you can also use healthcare cost comparison websites to find the cheapest option.

Is an open MRI more expensive?

Not necessarily. An open MRI is a machine with a large opening rather than a tube-like structure. It may cost more or less than a traditional MRI, depending on the facility, the type of equipment and the price negotiated with your insurance plan. The machinery and maintenance costs for open MRIs are lower, so that may translate into lower costs for the consumer. 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 as those from a traditional closed MRI.

Hospital vs private provider

MRIs are performed in hospitals, hospital outpatient departments and freestanding imaging centres. Some urgent care centres also offer MRI services, but most do not. MRIs performed in hospitals or hospital outpatient departments may be pricier than those performed at a freestanding radiology centre. There can also be cost variations from one hospital to another. One study found that brain MRIs, for instance, are cheaper at for-profit hospitals than nonprofit ones, and rural hospitals are more expensive than urban ones.

Are MRIs covered by insurance?

Your coverage depends on the individual policy you have. Many insurance plans require prior authorisation for an MRI, and you also 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. Common reasons for having one include diagnosis or evaluation of a specific medical condition, monitoring the progress of a known condition, imaging prior to surgery, evaluation of an acute injury, and management of chronic conditions, particularly those impacting the brain, spine or joints.

Is there usually a large copay?

The amount you're expected to chip in depends on your 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. If you have a deductible, you will have to meet that first before your insurance company will pay. A common coinsurance arrangement is for the insurance company to pay 80 per cent of the costs, leaving the patient responsible for 20 per cent. To determine your exact cost, check your insurance plan for details.

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. Hospitals must post prices for "shoppable" services, which often include MRIs.

What should I do if my insurance won't cover an MRI?

Your insurance may deny coverage for common reasons such as the scan not being considered medically necessary, you not being eligible under your specific health plan, the MRI being considered experimental for your condition, or the claim being filed too late. If you receive a denial letter, it should include detailed information about your right to file an appeal, including the specific reason the claim was denied and the deadlines for appeals. You have 180 days to file an internal appeal. If that fails, you can request an external review by an independent party.

If the appeals process is not successful, consider having an MRI at a freestanding MRI centre, which is usually less expensive than a scan performed at a hospital. If you are not using insurance, you should ask for the cash price and a good faith estimate. The American College of Radiology's search tool allows you to look for accredited imaging facilities near you.

The bottom line

An MRI is a valuable diagnostic tool, but the cost can vary widely. The average price is close to US$2,000, but the out-of-pocket cost for someone with insurance is usually considerably less. Where you live, the type of facility used and your insurance provider all impact the cost. Health insurance usually covers MRIs that have been deemed medically necessary or are needed for emergency situations. You may need to obtain prior authorisation or go to an in-network facility for a non-emergency. If you're planning an MRI, ask for a cost estimate in advance, compare facilities and check your insurance coverage so you know what to expect.