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How much does an MRI scan cost?

Unsure about the costs of MRI scans? Find out what to expect and what can be claimed back through Medicare or health insurance.

Undergoing a magnetic resonance imaging (MRI) scan can be a daunting experience, but this painless test is an important diagnostic tool used to help investigate a wide range of conditions and ailments that can be, depending on the circumstances, covered by both Medicare or health insurance.

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How much does an MRI cost?

Although the total cost of an MRI scan varies depending on the part of the body being imaged, costs generally range from $100 to $500. This is much better than in many overseas countries, where this procedure can cost several thousands of dollars.

The good news is that both Medicare and Australian health funds (in some cases) can pay towards the cost of the MRI scan. They do so in the following ways:

  • Public patient in a public hospital (no health insurance). Medicare covers 100% of the cost.
  • Private patient in a public hospital. Medicare covers 75% with the remaining “gap” covered by the health fund.
  • Private patient in a private hospital. Medicare once again covers 75% with the remainder paid by the health fund.
  • Out of hospital MRI scan with specialist referral. Medicare covers 85% of the cost.

Whether you are going the Medicare or health insurance route, always be sure to check that your treatment is covered or whether you will need to pay any upfront costs.
Take a closer look at health insurance and MRI scans

What medical issues have MRI scans covered by Medicare?

The Medicare Benefits Schedule (MBS) lists item numbers (conditions) for which benefits can be claimed. The reason there are multiple item numbers for the same condition is due to one scan being more comprehensive than the other, which is also why there is a difference in the fee charged.

Item numberPurpose of the scanFee chargedMedicare benefit
63551


63552

Head scan for a patient 16 years or older to investigate:

  • Unexplained seizures
  • Unexplained chronic headaches with suspected intracranial pathology
$403.20


$201.60

75%. $302.40
85%. $342.75


75%. $151.20
85%. $171.40

63554


63555

Spinal scan for a patient 16 years or older for suspected cervical radiculopathy$358.40


$179.20

75%. $268.80
85%. $304.65


75%. $134.40
85%. $152.35

63557


63558

Spinal scan for a patient 16 years or older for suspected cervical spine trauma$492.80


$246.40

75%. $369.60
85%. $418.90


75%. $184.80
85%. $209.45

63560


63561

Knee scan for a patient 16 years or older following acute knee trauma with:

  • Inability to extend the knee suggesting the possibility of acute meniscal tear
  • Clinical findings suggesting acute anterior cruciate ligament tear
$403.20


$201.60

75%: $302.40
85%: $342.75


75%: $151.20
85%: $171.40

63507


63508

Head scan for a patient under 16 years for any of the following:

  • Unexplained seizures
  • Unexplained headaches where significant pathology is expected
  • Paranasal sinus pathology, which has not responded to conservative treatment
$403.20


$201.60

75%. $302.40
85%. $342.75


75%. $151.20
85%. $171.40

63510


63511

Spinal scan for a patient under 16 years following radiographic examination for:

  • Significant trauma
  • Unexplained neck or back pain with associated neurological signs
  • Unexplained back pain where a significant pathology is suspected
$448.00


$224.00

75%. $336.00
85%. $380.80


75%. $168.00
85%. $190.40

63513


63514

Knee scan for a patient under 16 years following radiographic examination for internal joint derangement$403.20


$201.60

75%. $302.40
85%. $342.75


75%. $151.20
85%. $171.40

63516


63517

Hip scan for a patient under 16 years following radiographic examination for:

  • Suspected septic arthritis
  • Suspected slipped capital femoral epiphysis
  • Suspected Perthes disease
$403.20


$201.60

75%. $302.40
85%. $342.75


75%. $151.20
85%. $171.40

63519


63520

Elbow scan for a patient under 16 years following radiographic examination where a significant fracture or avulsion injury is suspected that will change management$403.20


$201.60

75%. $302.40
85%. $342.75


75%. $151.20
85%. $171.40

63522


63523

Wrist scan for a patient under 16 years following radiographic examination where scaphoid fracture is suspected$448.00


$224.00

75%: $336.00
85%: $380.80


75%: $168.00
85%: $190.40

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Richard Laycock

Richard is the insurance editor at finder.com.au. He is on a mission to make insurance easier to understand.

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