CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Illini Community Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $7,063
Cash Discount Price: $5,886
vs. Medicare Baseline: 19.82x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Illini Community Hospital is $7,063. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,886. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 19.82x the Medicare baseline. Located in 640 W Washington, Pittsfield, IL.

Cash / Self-Pay

$5,886

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,063

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: $5,886 (1651%)

Insurance Median: $7,063 (1982%)

Cash: $5,886 (1651% of Medicare)

Ins. Median: $7,063 (1982% 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 1982% of the Medicare baseline (a markup of 1882%). 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
Humana	$2,299 - $3,448	645%
Blue Cross Blue Shield	$4,042 - $10,006	1134%
Blue Access	$4,709 - $7,063	1321%
United Behavioral Health	$4,709 - $7,063	1321%
UnitedHealthcare	$6,278 - $9,418	1761%
Aetna	$6,671 - $10,006	1872%
Blue Preferred	$6,671 - $10,006	1872%
Cigna	$6,671 - $10,006	1872%
Health Link	$6,671 - $10,006	1872%
Private Healthcare Systems-Multi Plan Primary	$6,671 - $10,006	1872%
Health Link Ppo	$7,063 - $10,595	1982%
Private Healthcare Systems-Multi Plan Complementary	$7,063 - $10,595	1982%

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 $5,886.
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 Illini Community 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.