Evidence map›Paper›PMID 42142177›Full record

ArticlePediatric radiology2026

Payor and patient costs for rapid brain MRI: analysis from a single pediatric institution.

Shireen Hayatghaibi, Pradipta Debnath, Lisa Ulland, Brian Coley, Mishka Hoo Kim, Andrew Trout, Rama Ayyala

Abstract read
In one paragraph

Article in Pediatric radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Comment: limited MR, limited savings.Pediatric radiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shireen HayatghaibiDepartment of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. Shireen.Hayatghaibi@cchmc.org.
Pradipta DebnathDepartment of Medicine, Emory University, Atlanta, USA.
Lisa UllandDepartment of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
Brian ColeyDepartment of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
Mishka Hoo KimDepartment of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
Andrew TroutDepartment of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
Rama AyyalaDepartment of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background"Rapid" "Fast" or "Abbreviated" MRI examinations, which leverage fewer sequences to answer a targeted clinical question, are increasingly being explored as clinical tools.

objectiveThe purpose of this study was to evaluate and compare payor costs and patient out-of-pocket costs for brain MRI without contrast compared to a rapid brain MRI among commercially insured patients at a quaternary academic children's hospital. MATERIALS AND

methodsWe performed a retrospective search to identify patients with private insurance who underwent an outpatient brain MRI without contrast (standard MRI) or rapid brain MRI at our quaternary academic children's hospital. Examinations lacking complete payment information were excluded, and only the first exam per patient was included. All rapid MRIs were included; an equal number of standard MRIs were randomly sampled by month. For rapid MRI examinations, we calculated the frequency of cases in which the payor did not recognize the limited modifier, as indicated by the payor reason codes. For all examinations, we calculated the (1) payor cost (the amount reimbursed for the exam) and (2) the patient's total out-of-pocket cost, calculated as the sum of the deductible, coinsurance, and co-payment. Descriptive statistics were used and means were compared between groups using Student's t test.

resultsOur sample included 147 standard MRIs and 166 rapid MRIs (coded with the 52 modifier). Most examinations included patient cost sharing: 77% (113/147) of standard MRIs and 69% of rapid MRIs (115/166). Payor reimbursement differed (P<0.001) by examination, with higher payor costs for standard MRI (mean, $2,760; SD, $1,187 vs. mean, $1,986; SD, $198) for rapid MRI. Among examinations with cost sharing, the mean total out-of-pocket costs were similar between examination types (standard, $1,206 vs rapid, $1,285; P=0.55). In 43% (71/166) of rapid MRI examinations, the payor did not recognize the limited modifier.

conclusionAlthough rapid brain MRIs reduced payor reimbursement, patient out-of-pocket costs remained unchanged. Inconsistent recognition of the limited modifier underscores the need for updated CPT codes and reimbursement policies aligned with evolving imaging practices.

Indexed as

Brain DiseasesHealth Care CostsHealth ExpendituresMagnetic Resonance ImagingAdolescentBrainChildChild, PreschoolFemaleHospitals, PediatricHumansInfantMaleRetrospective StudiesBrainDeductibles and coinsuranceMagnetic resonance imagingPolicy

Identifiers

PMID42142177
PMCPMC13357380

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.