CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Anderson Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,696
  • Cash Discount Price: $2,394
  • vs. Medicare Baseline: 6.96x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Anderson Hospital is $1,696. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,394. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.96x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
$2,394

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,696

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $2,394 (982%)
Insurance Median: $1,696 (696%)
Cash: $2,394 (982% of Medicare)
Ins. Median: $1,696 (696% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 696% of the Medicare baseline (a markup of 596%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 Care Service Corporation $152 - $2,190 62%
Tricare $182 - $4,590 75%
Humana $184 - $4,785 75%
Medicare (plans) $184 - $4,785 75%
UnitedHealthcare $184 - $4,785 75%
Aetna $252 - $4,785 103%
Essence $256 - $5,028 105%
Devoted Health Ppo $257 - $4,881 105%
Clear Springs Health $259 - $4,929 106%
Medicaid / KanCare $303 - $304 124%
Ambetter / Centene $371 - $7,079 152%
Blue Choice $371 - $7,079 152%
Mercy Benefit Admin $580 238%
Mercy Aco $593 243%
Hopetrust $639 - $12,205 262%
Work Comp $1,310 - $26,600 537%
Healthlink $1,797 - $1,865 737%
Self Pay $2,394 - $25,000 982%
Blue Cross Blue Shield $2,568 - $2,660 1053%
Cigna $3,351 1375%
Multiplan/Phcs $3,591 1473%
Beech Street Corporation $4,309 1768%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals