CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: UW Health

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $305
Cash Discount Price: $1,036
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at UW Health is $305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,036. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.86x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$1,036

Average discount available for prompt cash payment at this facility.

Insurance Median

$305

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: $1,036 (291%)

Insurance Median: $305 (86%)

Cash: $1,036 (291% of Medicare)

Ins. Median: $305 (86% 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
Aetna	$178 - $3,303	50%
Blue Cross Blue Shield	$178 - $6,475	50%
Humana	$178 - $356	50%
Medicare (plans)	$178 - $392	50%
Mychoice Wi Medical Adv	$178 - $356	50%
UnitedHealthcare	$178 - $3,516	50%
Medicaid / KanCare	$194 - $297	54%
Quartz Aso	$307 - $2,498	86%
Quartz Fully Insured	$307 - $1,587	86%
Cigna	$345 - $3,652	97%
Ecoh	$420 - $3,602	118%
Hfn	$420 - $3,602	118%
Alliance Premier Network	$460 - $2,497	129%
The Alliance	$499 - $3,214	140%
Workers Comp	$2,553	716%
Wps	$2,688 - $3,237	754%
Beloit Healt System	$3,118 - $4,128	875%
Wps Ppo	$3,538	993%
Mercy Care	$3,763 - $4,532	1056%
Mercycare	$4,271	1198%
First Health/Coventry	$4,499	1262%
Health Payment Systems	$5,338	1498%
Healthsmart	$5,338	1498%
Sheboygan Employers Health Network	$5,694	1598%
Multiplan	$6,363	1785%

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 $1,036.
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 UW Health 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.