CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,252
Cash Discount Price: $1,470
vs. Medicare Baseline: 5.14x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Thomas H Boyd Memorial Hospital is $1,252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,470. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.14x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$1,470

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,252

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: $1,470 (603%)

Insurance Median: $1,252 (514%)

Cash: $1,470 (603% of Medicare)

Ins. Median: $1,252 (514% 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 514% of the Medicare baseline (a markup of 414%). 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	$187 - $1,875	77%
Blue Cross Blue Shield	$187 - $2,757	77%
Health Alliance Mcr Adv	$187 - $1,875	77%
UnitedHealthcare	$187 - $1,912	77%
Wellcare Mcr Adv-All Plans	$187 - $1,875	77%
Humana	$189 - $1,894	78%
Health Alliance-All Other Plans	$225 - $2,250	92%
Ambetter / Centene	$243 - $2,437	100%
Cigna	$262 - $2,621	107%
Multiplan-All Plans	$275 - $2,757	113%
Healthlink Hmo	$279 - $2,794	114%
Healthlink Il Only	$279 - $2,683	114%
Healthlink Ppo-All Other Plans	$316 - $3,161	130%
Hfn Zelis-All Plans	$334 - $3,345	137%
Meridian Hp Mcaid-All Plans	$1,255	515%
Molina Mcaid-All Plans	$1,255	515%

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 $1,470.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Thomas H Boyd Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.