CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,771
Cash Discount Price: $4,304
vs. Medicare Baseline: 7.77x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Thomas H Boyd Memorial Hospital is $2,771. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,304. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.77x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$4,304

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,771

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: $4,304 (1208%)

Insurance Median: $2,771 (777%)

Cash: $4,304 (1208% of Medicare)

Ins. Median: $2,771 (777% 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 777% of the Medicare baseline (a markup of 677%). 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	$288 - $3,032	81%
Blue Cross Blue Shield	$288 - $4,459	81%
Health Alliance Mcr Adv	$288 - $3,032	81%
UnitedHealthcare	$288 - $3,093	81%
Wellcare Mcr Adv-All Plans	$288 - $3,032	81%
Humana	$291 - $3,062	82%
Health Alliance-All Other Plans	$346 - $3,638	97%
Ambetter / Centene	$375 - $3,942	105%
Cigna	$403 - $4,239	113%
Multiplan-All Plans	$424 - $4,459	119%
Healthlink Hmo	$429 - $4,518	120%
Healthlink Il Only	$429 - $4,340	120%
Healthlink Ppo-All Other Plans	$486 - $5,113	136%
Hfn Zelis-All Plans	$514 - $5,410	144%
Meridian Hp Mcaid-All Plans	$2,117	594%
Molina Mcaid-All Plans	$2,117	594%

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 $4,304.
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 Thomas H Boyd Memorial 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.