CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Mc Donough District Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $572
  • Cash Discount Price: $2,177
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mc Donough District Hospital is $572. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,177. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.60x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$2,177

Average discount available for prompt cash payment at this facility.

Insurance Median
$572

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $2,177 (611%)
Insurance Median: $572 (160%)
Cash: $2,177 (611% of Medicare)
Ins. Median: $572 (160% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Health Alliance $62 - $5,859 17%
Hfn $98 - $5,925 27%
UnitedHealthcare $98 - $5,925 27%
Aetna $104 - $6,583 29%
Humana $104 - $5,925 29%
Medicaid / KanCare $104 - $6,583 29%
Medicare (plans) $104 - $399 29%
Meridian $104 - $399 29%
Molina $104 - $6,583 29%
Mutual Medical $104 - $6,583 29%
Veteran Affairs $104 - $399 29%
Tricare $372 104%
Blue Cross Blue Shield $511 - $6,583 143%
Springfield Health $552 - $5,398 155%
Consociate $572 - $5,596 160%
Trilogy $572 - $5,596 160%
Blue Choice $606 - $5,925 170%
Current Health $606 - $5,925 170%
Healthlink $606 - $6,188 170%
Preferred Plan $639 - $6,254 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals