CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Warner Hospital and Health Services

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $3,047
Cash Discount Price: $3,740
vs. Medicare Baseline: 12.50x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Warner Hospital and Health Services is $3,047. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,740. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 12.50x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$3,740

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,047

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: $3,740 (1534%)

Insurance Median: $3,047 (1250%)

Cash: $3,740 (1534% of Medicare)

Ins. Median: $3,047 (1250% 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 1250% of the Medicare baseline (a markup of 1150%). 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	$915 - $3,254	375%
Blue Cross Blue Shield	$915 - $3,751	375%
Harmony Hp Mcaid-All Plans	$915	375%
Medicaid / KanCare	$915	375%
Meridian Hp-All Plans	$915	375%
Molina-All Other Plans	$915	375%
Health Alliance Med Adv	$1,498 - $1,569	615%
Humana	$1,498 - $3,254	615%
Molina Mcr/Mcd Dual	$1,498 - $1,569	615%
UnitedHealthcare	$1,498 - $3,254	615%
Wellcare Mcr Adv-All Plans	$1,498 - $1,569	615%
Healthlink Hmo	$2,849 - $2,986	1169%
City Of Clinton (Employees Serv)-All Plans	$2,922 - $3,062	1199%
Cigna	$3,032 - $3,177	1244%
Caterpillar-All Plans	$3,105 - $3,254	1274%
Multiplan Phcs-All Plans	$3,105 - $3,254	1274%
Health Alliance-All Other Plans	$3,214 - $3,368	1318%
Healthlink Ppo/Work Comp-All Other Plans	$3,214 - $3,368	1318%
Consociate Care Ppo-All Plans	$3,287 - $3,445	1348%
Hfn Ppo/Epo-All Plans	$3,287 - $3,445	1348%
Three Rivers-All Plans	$3,470 - $3,636	1423%

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 $3,740.
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 Warner Hospital and Health Services 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.