The same MRI, one health system, two Wyoming hospitals

Banner Health runs two hospitals in Wyoming that could hardly differ more in scale. Banner Wyoming Medical Center in Casper is the largest hospital in the state. Community Hospital in Torrington is a 25-bed Critical Access Hospital near the Nebraska line — small enough that it does not keep a fixed MRI scanner at all. Its imaging arrives on a mobile trailer that visits on a schedule.

Same system, same corporate parent. We looked at one procedure both of them post: an MRI of the brain, before and after contrast — CPT 70553. Here is what each hospital lists for that one code in its own machine-readable price file, retrieved June 27, 2026.

Casper posts a cash price of $1,200.78 and a gross (“chargemaster”) charge of $2,859. Torrington posts a cash price of $1,934.59 and a gross charge of $2,816. Two things stand out. The two gross charges land within $43 of each other. And the smaller, more rural hospital posts the higher cash price. Every figure here is the number the hospital itself published; these are posted prices, not quotes, and your own bill can differ.

The honest part

This is where a fair reading has to slow down, because it would be easy — and wrong — to call this simple gouging. A 25-bed rural hospital genuinely costs more per scan than a big-city flagship, and the reason is arithmetic. Fixed costs — the scanner, the service contract, the technologist’s shift — spread across however many patients come through the door. Torrington runs an estimated 500 MRI scans a year; Casper runs about 5,000. Ten times the volume means each Casper scan carries a tenth of the fixed cost.

Our bottom-up estimate reflects exactly that. Building the cost up from labor, contrast, equipment, and overhead, we estimate the brain MRI costs about $635.69 to deliver at Torrington and about $225.36 at Casper — the rural scan really does cost roughly 2.8× as much. The labor and contrast lines are identical at both hospitals; the entire gap is capital and overhead. Torrington’s equipment line alone is $400 per scan — a leased mobile scanner spread over 500 visits — against $89.14 at Casper, which owns its machine and runs it 5,000 times a year. So some of the difference between these two hospitals is real, and defensible.

The gap that remains

Now set the cost estimates next to the charges. Torrington’s posted cash price is about 3.0× our estimate of what its scan costs to deliver, and its gross charge about 4.4×. Casper’s posted cash is about 5.3× its (lower) estimated cost, and its gross charge about 12.7×. Take even the higher of the two cost estimates — Torrington’s $635.69, the legitimately more expensive rural scan — and both hospitals’ gross charges still sit roughly 4.4–4.5× above it.

The tell is in those near-identical gross charges. If a charge tracked cost, Casper’s — built on a scan that costs roughly a third of Torrington’s — would come in far lower. Instead the two land $43 apart. The charge is set off a chargemaster, not derived scan by scan from what the procedure costs to deliver. The small hospital’s higher cost is real; it simply is not what is setting the price.

One wrinkle sits underneath Torrington’s number. As a Critical Access Hospital, it is paid by Medicare on the basis of its own reported costs — roughly 101% of cost — rather than the standard outpatient fee schedule, which is why the Medicare reference we show for Torrington ($635.69, basis cost_based) is set to its estimated cost, while Casper is measured against the national OPPS technical rate ($356.43). That cost-based payment shapes what a patient can actually end up owing at a small rural hospital, in a way that deserves its own note — more on that in a coming article.

Why it matters, and what to do

Two people can get the same brain MRI from the same health system and be charged very differently, and the number each hospital posts is a starting point you are entitled to see before you go.

• Compare the posted prices. Our live pages for Banner Torrington and Banner Casper show each hospital’s posted prices against the Medicare reference, and the comparison page for CPT 70553 ranks every hospital in our lineup for this exact scan.
• Ask for a written estimate. Posted prices are not quotes. Before you schedule, give the hospital the code — 70553 — and ask for a good-faith estimate in writing; if you are uninsured or paying cash, that estimate is your right.

How we estimated cost

The two cost figures above are bottom-up estimates, not the hospitals’ books. We build each one from named, individually documented assumptions — technologist labor, contrast media, equipment capital, and facility overhead — each carrying a confidence label, adjusted for per-hospital scan volume and, at Torrington, for the fact that its MRI arrives on a leased mobile trailer rather than a scanner it owns.

As an independent cross-check, we also run each hospital’s gross charge through the cost-to-charge ratio it reported on its own Medicare cost report (Worksheet C, diagnostic radiology, FY2024). That check lands at about $574.75 for Torrington and $639.84 for Casper. The two methods do not line up to the dollar — for Casper they range from about $225 to $640 — but all four of these cost estimates fall in the hundreds of dollars, well under a thousand, and far below posted charges that run from $1,200.78 to $2,859.

These numbers are frozen from our July 2026 dataset; both hospitals’ prices were retrieved June 27, 2026, and the live pages linked above stay current as the data refreshes. The site’s full published dataset is available on GitHub, and our sources and method are laid out on the about page.