Grand Junction and Mesa County · Imaging costs for 2027
How Much Is an MRI on Medicare Advantage in Grand Junction?
For 2027, the 13 general Advantage plans sold in Mesa County file a top copay of $250 to $400 for an MRI or CT scan. It's a flat dollar amount with no deductible in front of it, and every one of those plans can ask for approval before the scan.
The short answer
- Original Medicare: 20% of the Medicare-approved amount after the Part B deductible, per Medicare.gov.
- Medicare Advantage in Mesa County, 2027: a flat copay per scan, topping out at $250 on three plans and as high as $400 on one. No deductible on any of the 13.
- Approval first: all 13 plans tell CMS that outpatient imaging may need prior authorization.
- It counts toward the cap: scan copays add up toward each plan's yearly out-of-pocket maximum ($4,900 to $9,850 here).
The standard answer: what Medicare itself says
Medicare Part B covers an MRI or CT scan when your doctor orders it to find or treat a medical problem. Medicare.gov files these under "diagnostic non-laboratory tests": after the Part B deductible, "you pay 20% of the Medicare-approved amount" when the test is done in a doctor's office or an independent diagnostic testing facility. Done in a hospital outpatient department, there's a hospital copayment as well. The 2027 Part B deductible hadn't been announced when this was written; it was $283 for 2026 (Medicare.gov costs page).
A Medicare Advantage plan replaces that 20% with its own price. Most people asking this question are on one of those plans, so the rest of this post is about what the Grand Junction plans actually charge for 2027.
MRI and CT copays on every general Mesa County plan
Each plan files its imaging cost sharing in CMS's 2027 plan benefit file. MRI and CT fall under "diagnostic radiological services," and each plan lists a low and a high copay for that category. The high number is the one to plan around. Where I could check it against a carrier's own 2027 plan page, the top of the filed range is the MRI price the plan page shows.
| Plan | MRI / CT scan | X-ray | Monthly premium / yearly cap |
|---|---|---|---|
| Aetna Medicare Eagle (PPO, no drug coverage) H5521-378 | $0–$250 | $10 | $0 / $5,500 |
| Aetna Medicare Value Care (PPO) H5521-443 | $0–$250 | $10 | $18.40 / $7,150 |
| HealthSpring True Choice (PPO) H7849-147 | $0–$250 | $50 | $0 / $9,500 |
| Select Health Medicare Essential (HMO) H1994-029 | $0–$300 | See plan | $0 / $4,900 |
| HealthSpring Preferred (HMO) H2752-007 | $0–$300 | $5–$40 | $0 / $7,150 |
| Anthem Medicare Advantage (HMO-POS) H4346-012 | $5–$300 | $5–$40 | $0 / $9,850 |
| HumanaChoice H5216-223 (PPO) H5216-223 | $0–$300 | $0–$50 | $20 / $4,900 |
| Humana Value Choice (PPO) H5216-078 | $0–$345 | $0–$145 | $0 / $6,250 |
| Humana Essentials Plus Giveback (PPO) H5216-435 | $0–$345 | $0–$145 | $0 / $7,850 |
| Humana USAA Honor Giveback (PPO, no drug coverage) H5216-436 | $0–$345 | $0–$145 | $0 / $6,200 |
| Aetna Medicare Signature (HMO) H5593-007 | $0–$350 | $30 | $0 / $5,900 |
| Aetna Medicare Signature (PPO) H5521-207 | $0–$390 | $20 | $0 / $7,150 |
| Select Health Medicare Veterans (HMO, no drug coverage) H1994-033 | $0–$400 | $50 | $0 / $6,750 |
Sources: CMS 2027 benefit file, section 8b (outpatient diagnostic and therapeutic radiology), in-network amounts, sorted by top scan copay; premiums and caps from the CMS CY2027 landscape. "See plan" means no separate X-ray copay was filed. You still pay your Part B premium. Listing a plan is reporting, not a recommendation, and we do not offer every plan available in your area.
Three things stand out. The spread from the lowest top copay to the highest is $150 a scan. No plan puts a deductible in front of imaging. And radiation therapy, the other half of the same benefit section, is filed as 20% coinsurance on all 13 plans, so cancer treatment is priced very differently from a diagnostic scan.
Why the copay has a range
A $0-to-$345 entry doesn't mean you'll be charged a random number. Plans split imaging by type of service and sometimes by where it's done, a free-standing imaging center versus a hospital outpatient department. The plan's Summary of Benefits and Evidence of Coverage list which scans fall where.
Before you schedule, ask the plan two questions: what's my copay for this scan at this location, and has the authorization been approved? If a free-standing center and a hospital department are both in network, the answer can differ.
Expecting a scan, or a few of them, next year?
We'll price the imaging, specialist and hospital lines on your current plan against the Mesa County plans we offer, with your doctors and prescriptions in the same pass. Free, at our Grand Junction office or by phone.
Book a call →Prior authorization is the step that delays scans
All 13 plans answered "yes" to CMS's question about whether outpatient imaging can require authorization. That doesn't mean every X-ray needs approval; advanced scans such as MRI, CT and PET are where it usually comes up. Your doctor's office usually submits the request; if it's denied, you can appeal. Our prior authorization explainer covers how that process and the appeal timelines work.
Original Medicare generally doesn't require prior authorization for these scans. The one check it asks for is different: an imaging center outside a hospital has to be accredited, a point I cover in what Medicare pays for lab work and imaging.
Three scans in a year: how the math adds up
Say a knee problem turns into an MRI in March, a follow-up MRI in September and a CT scan in between. On the plan with a $250 top copay, that's $750. On the $400 plan, it's $1,200. Either way those copays count toward the yearly cap, along with specialist visits and any hospital stay. Our Grand Junction hospital copay post shows how fast a single admission can move you toward that cap.
With Original Medicare and Medigap Plan G, the same three scans cost the Part B deductible once, and Plan G pays the 20% after that. That's the real trade: a monthly Medigap premium in exchange for predictable imaging bills. For someone with a known condition that needs regular scans, run the numbers both ways. For someone who rarely sees a doctor, the Advantage copay may never come up.
What to check before you pick a 2027 plan
- The top imaging copay, not the bottom one, from the plan's Summary of Benefits.
- Where your scans are usually done in Grand Junction, and whether that location is in the plan's 2027 network. Our network-check guide walks through it.
- The yearly cap, because a year with several scans plus a hospital stay is where it matters. See 2027 caps in Grand Junction.
Open Enrollment runs through December 7, and changes take effect January 1.
How we know all this: the Medicare On Main Data Desk frames every article with public data. Here that means CMS's 2027 plan benefit and landscape files and Medicare.gov's diagnostic test and cost pages, all read November 6, 2026. Benefits can differ in a plan's final documents, so confirm them in its Summary of Benefits and Evidence of Coverage. Carrier names are factual reporting, not endorsement. This is education, not advice. Compare plans with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.
Frequently asked questions
How much does an MRI cost with Medicare Advantage?
It's a flat copay the plan sets each year, not a percentage. For 2027 the 13 general Medicare Advantage plans in Mesa County, Colorado file a top MRI and CT copay between $250 and $400 a scan, with no deductible in front of it. What you pay inside that range depends on the type of scan and where it's done, which the plan's Summary of Benefits spells out.
Does Medicare cover MRI scans?
Yes, when your provider orders one to diagnose or treat a medical problem. Medicare.gov lists MRI and CT scans as diagnostic non-laboratory tests under Part B. On Original Medicare you pay 20% of the Medicare-approved amount after the Part B deductible in a doctor's office or independent testing facility. On an Advantage plan you pay the plan's copay instead.
Do I need prior authorization for an MRI on Medicare Advantage?
Often, yes. All 13 general Mesa County plans tell CMS that outpatient imaging can require the plan's approval. In practice your doctor's office sends the request, but it's worth asking whether it's been approved before you drive to the appointment.
Is an MRI cheaper with a Medigap plan?
Usually. With Original Medicare plus Medigap Plan G, you pay the Part B deductible once a year (it was $283 in 2026) and Plan G pays the 20% after that, so a second or third scan costs nothing more. Plan N works the same way for imaging. The trade-off is the Medigap premium every month.
Does an MRI copay count toward the out-of-pocket maximum?
Yes. In-network copays for covered Part B services, imaging included, count toward the plan's yearly maximum. In Mesa County for 2027 those caps run from $4,900 to $9,850 on the general plans, and once you reach yours the plan pays 100% of covered in-network care for the rest of the year.