CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Carle Foundation Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,378
Cash Discount Price: $7,928
vs. Medicare Baseline: 6.67x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Carle Foundation Hospital is $2,378. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,928. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.67x the Medicare baseline. Located in 611 West Park Street, Urbana, IL.

Cash / Self-Pay

$7,928

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,378

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: $7,928 (2224%)

Insurance Median: $2,378 (667%)

Cash: $7,928 (2224% of Medicare)

Ins. Median: $2,378 (667% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 667% of the Medicare baseline (a markup of 567%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$374 - $6,358	105%
Blue Cross Blue Shield	$374 - $5,153	105%
Humana	$374 - $393	105%
Meridian	$374 - $793	105%
Molina	$374 - $2,378	105%
UnitedHealthcare	$374 - $4,907	105%
Wellcare	$374	105%
Community Partners Health Plan (Cphp)	$4,665	1309%
Cigna	$6,184	1735%
Multiplan/Phcs	$6,342	1779%
Healthlink	$6,739	1891%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $7,928.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Carle Foundation Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.