Have you ever shopped around for MRI?

When I was starting to be diagnosed I just went to the MRI place next door because it was fast but my pre-MRI copay was like 1400 dollars I cant remember exactly.. With  insurance, I think that was in group. Have any of you shopped around before you got your MRI?
There are two places near where I work, It seems like MRI places are popping up all over just like labs it's not just a hospital thing anymore.
Now that I have been diagnosed it sounds like it won't be my last MRI. How often have you had an MRI and do you have any tips on getting a good MRI or getting a MRI if your flat broke?

[Lulu54]

How often you have an MRI will depend on your symptoms that the neuro may see changing and the doctor's general attitude about routine MRI's.

Right now my neuro is doing one a year to monitor my progress to make sure the copaxone is working for me.  I can see that slowing down if I appear stable on this DMD.

If I were to suddenly have a progression that couldn't be explained I would definitely be back in the MRI to take a look at the evidence.

You certainly can shop around for MRI services -there are ones here in trailers that Iwouldn't pay $50 to use - they are fine imaging bones and looking for big things but those lesions are a different story.  You should feel confident in asking whaat type of MRI equipment they have (the Tesla strength - should be at least 1.5T) and how often they do scans to MS protocol.  

Good luck in figuring this out.  
Lulu

[Sumanadevii]

With what I know today (from this site), I shop.  I not only shop, I am a wise shopper!!!

[HoustonDogLove]

What have you found in your shopping so far? are the ones in the strip mall shopping centers any different from the ones in the hospital. The one I went to was next to the my meurologists office but still in a strip so to say.  There's one close by but in a strip center but nothing resembling a dr.s office close by.

[Sumanadevii]

My first neuro, the one that I wasted three and a half years with the diagnose of a pinched nerve in my neck, sent me to a strip mall MRI place.  When I walked into his office, I was already in bad shape.  I was using a wheelchair for any distance walking.  My pain level was ten.  I didn't know the word fatigue and was unable to explain to him that even to bath was a chore.  

What did I find?  I found outdated equipment that was not high powered enough to read the lesions on my spine.  It did show one small lesion on my brain which was put off to age.  I found only a report from a radiologist and not a neuroradiiologist.  

Today I make sure what equipment is being used and who is doing the reading. I don't hesitate to question and wouldn't hesitate to refuse treatment and look elsewhere.  Fool me once not twice.  

[wiggles94]

YOU ARE smart to be thinking about this.

I was dx about a year ago, and had an MRI 6 months later, and am having another one in a few weeks.  

My neuro's office told me where they would like me to go based on how well they do the tests and read them.  They have their fav place.

My ins is very good so I haven't had to worry about that part.

[jensequitur]

I shopped around specifically for a 3T MRI, because there aren't any in Fort Worth.  I had to go to Dallas.  It cost me more than the .7T MRI ($250 instead of $100,) but it was worth it.  But then again it helps to have insurance.

[RedFlame]

I think it is smart to shop around----it's your body and you have to stand up for yourself.  Find a 3T.

Red

[HoustonDogLove]

So a 3T is 2x's stronger that a 1.5 T I'm guessing. I have BCBS and I  thought it was pretty good. Maybe the one I went to wasn't actually in my group.

[Lulu54]

No the increase in magnetic strength is exponential - Bob can explain the differed.  

A 1.5T is usually sufficient to dx obvious DX where the lesions are in classic locations.  I was dx'd on a 1.5T - both my brain and spine showed clearly the problems.  But any others here have needed that extra oomph in the strength to get their lesions visible for dx.

BCBS coverage varies according to your plan - there are fair, good and excellent BCBS plans.  Its hard to second guess what you plan might cover.

[Sumanadevii]

Here is the MedHelp page Quix put together on MRI's.  In her own words

Lower Power MRI Machines Miss Lesions

Furthermore, we can't ignore the data from the repeated transition between generations of MRI machines.  The power of an MRI machine is measured by its magnet strength, using the unit of measure, the Tesla.  Its symbol is the letter "T" like "HP" indicates Horsepower.  The old studies show that the 1T machines revealed a greater number of lesions than the machines with <1T power.  The current MRI Guidelines specify that for the purposes of diagnosis the minimum power of the MRI machine must be 1T.  When the 1.5T machines came out it was clear that they were superior to the lower MRIs at picking up lesions.  The new generation of machine now in fairly common use in some parts of the country is a 3T in power.  Back to back studies against the 1.5T machine show that the higher power 3T machine will pick up about 25%  more lesions.  And, yes, the newest high-intensity MRI, like the 7T, are picking up yet more than the 3T (data from autopsy MRIs).  The 7T is not in common clinical use, but is being studied.  We can only surmise that we are still missing a certain percentage of MRI lesions.

The spinal cord is especially hard to get clear images on.  This is due to movement from breathing, pulsations of the heart and aorta, and the density of the spinal column and the body.  It is also affected by the fact that the spinal cord is surrounded by fluid, CSF.  The higher intensity MRIs pick up a much greater number of lesions.

http://www.medhelp.org/tags/health_page/7687/Multiple-Sclerosis/How-Can-a-Person-with-MS-Have-a-Negative-MRI?hp_id=161

Sorry but I agree 100 percent and trust her judgement.  My body...repeat...my body would not be in the condition it is today had I used a 3t.  The 1.5 picked up zero lesions on my spine and one tiny on the brain.  Three years later...What a surprise ...12 lesions on the spine and one tiny one on the brain.

[twopack]

I believe Quix has qualified her opinion more recently by saying that the software used with a 1.5T magnet can make a huge difference in it's imaging.  She does prefer the 3T for imaging the spine when it is available since those lesions are harder to capture.

Quix has also said that the use of MS protocol, which images thinner 'slices' with no spacing between, is more important than insistance on a 3T magnet strength. At least I'm pretty sure she's one person who pointed that out.

I've never heard a recommendation for open MRI use when imaging for MS diagnosis.  I cancelled one on the spot when I arrived and found the unit was open.

My 1990 MRI (a portable unit housed in a trailer that served several hospitals early in the MRI era) showed up several brain lesions, including one in the medulla.  I don't know what strength that unit was.  Certainly <1.5Tesla.  

I made a point to locate a 3T unit a few months ago to have the best chance of finding spinal cord lesions.  None showed up even though some of my symptoms indicate they exist.  A few brain lesions appeared larger than on the 1.5T images from the prior year (without enhancement to indicate new damage).  There were NO additional lesions visible.  I'm pretty much done with looking for them.

My MSologist sat down with me and compared all the images side by side.  No new lesions visible was good news but in the end, meant little.  I'm glad I investigated and found a place to get the best image possible at reasonably increased cost.  It was worth doing once but would not have been worth a huge extra expense to satisfy a lesion counter.  

Personally, I have very mixed thoughts about the value of following disease progress with frequent MRIs after diagnosis.  I doubt I'll be curious enough to repeat the additional travel time and expense in the near future.  Fortunately, my doc looks at the clinical picture over imaging alone so I doubt he'll insist on frequent pics.  Your neuro may follow different protocols.

Your insurance representative should be able to give you a close guess on actual cost to you.  Mine was a % of the allowable charge for a less preferred site.  The service provider gave me a rough estimate of actual charges that was similar to past MRI charges.  I didn't know exactly what it would cost but I knew I'd be well within my willingness limit.

Mary

[twopack]

I had to go take a look to be sure I wasn't misquoting our wise leader.  I believe I did ok.  Check it out yourselves.

Reference Dr. Quix's comments of December 12, 2010 (presently next to last entry on page):
http://www.medhelp.org/posts/Multiple-Sclerosis/MRIs-and-MS/show/1415113?personal_page_id=302#post_6475152

Mary

[HVAC]

I found out an independent diagnostic imaging place is way cheaper than the hospital where my Doctor works. Uses same machines, same trailer set up, and same software and the Doctors at the Hospital use this imaging place all the time to save patients money.

I thinks a brain MRI 1.5 is $3000 retail cost. C and Thoracic Spine and are a lot more. Many insurances are looking at people to pay a third of the cost from what I hear in health care briefings.

Alex

[jensequitur]

I will say that if your insurance supports relatively cheap MRIs, go for it.  You should always get a new MRI that's at least as strong as the MRI that got you diagnosed.

The thing about repeat MRIs is to check the efficacy of your DMD.  They're checking for new lesions, and if they find any, then maybe the DMD isn't working and you should find another one.  Sometimes lesions don't show themselves, aside from personality changes or cognitive deficits.

My old neuro did not do this - I was on Copaxone for 2 1/2 years, and had three relapses a year.