CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Northwestern Medicine McHenry

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,943
Cash Discount Price: $5,385
vs. Medicare Baseline: 11.06x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Northwestern Medicine McHenry is $3,943. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,385. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.06x the Medicare baseline. Located in 4201 Medical Center Drive, McHenry, IL.

Cash / Self-Pay

$5,385

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,943

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: $5,385 (1511%)

Insurance Median: $3,943 (1106%)

Cash: $5,385 (1511% of Medicare)

Ins. Median: $3,943 (1106% 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 1106% of the Medicare baseline (a markup of 1006%). 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	$1,485 - $4,039	417%
Mercy Care Health Plans [5013]	$2,335	655%
Blue Cross Blue Shield	$2,608 - $7,693	732%
Healthlink [125]	$3,846	1079%
Choicecare [177]	$4,093	1148%
Multiplan/Phcs [142]	$4,847 - $7,693	1360%
The Alliance [1703]	$4,941	1386%
Health'S Finest Network [126]	$5,385 - $5,616	1511%
Cigna	$5,770	1619%
Beechstreet [176]	$6,154	1727%

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 $5,385.
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 Northwestern Medicine McHenry 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.