CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Presence Saint Joseph Hospital - Chicago

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $410
Cash Discount Price: $1,404
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Presence Saint Joseph Hospital - Chicago is $410. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,404. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.15x the Medicare baseline. Located in 2900 North Lake Shore Drive, Chicago, IL.

Cash / Self-Pay

$1,404

Average discount available for prompt cash payment at this facility.

Insurance Median

$410

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: $1,404 (394%)

Insurance Median: $410 (115%)

Cash: $1,404 (394% of Medicare)

Ins. Median: $410 (115% 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.

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
Cigna	$244 - $486	68%
UnitedHealthcare	$368 - $828	103%
Aetna	$372 - $2,510	104%
Blue Cross Blue Shield	$372 - $3,035	104%
Humana	$372 - $410	104%
Medicare (plans)	$372 - $410	104%
Tricare	$372	104%
Bright Health	$465	130%
Smarthealth	$521	146%
Ambetter / Centene	$603	169%

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 $1,404.
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 Presence Saint Joseph Hospital - Chicago 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.