CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Anderson Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,797
Cash Discount Price: $3,434
vs. Medicare Baseline: 5.04x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Anderson Hospital is $1,797. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,434. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.04x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$3,434

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,797

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: $3,434 (963%)

Insurance Median: $1,797 (504%)

Cash: $3,434 (963% of Medicare)

Ins. Median: $1,797 (504% 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 504% of the Medicare baseline (a markup of 404%). 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
Health Care Service Corporation	$255 - $3,142	72%
Tricare	$296 - $4,604	83%
Humana	$299 - $4,800	84%
Medicare (plans)	$299 - $4,800	84%
UnitedHealthcare	$299 - $4,800	84%
Medicaid / KanCare	$304 - $511	85%
Aetna	$368 - $4,800	103%
Essence	$374 - $5,044	105%
Devoted Health Ppo	$375 - $4,896	105%
Clear Springs Health	$379 - $4,944	106%
Ambetter / Centene	$542 - $7,100	152%
Blue Choice	$542 - $7,100	152%
Mercy Benefit Admin	$810	227%
Mercy Aco	$828	232%
Hopetrust	$935 - $12,242	262%
Work Comp	$1,795 - $26,600	504%
Healthlink	$1,797 - $1,865	504%
Self Pay	$3,434 - $25,000	963%
Blue Cross Blue Shield	$3,683 - $3,815	1033%
Cigna	$4,244	1191%
Multiplan/Phcs	$5,151	1445%
Beech Street Corporation	$6,181	1734%

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 $3,434.
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 Anderson 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.