CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,674
Cash Discount Price: $2,069
vs. Medicare Baseline: 6.87x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sarah D Culbertson Memorial Hospital is $1,674. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,069. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.87x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$2,069

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,674

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: $2,069 (849%)

Insurance Median: $1,674 (687%)

Cash: $2,069 (849% of Medicare)

Ins. Median: $1,674 (687% 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 687% of the Medicare baseline (a markup of 587%). 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	$68 - $3,504	28%
Blue Cross Blue Shield	$68 - $3,815	28%
Molina Mmai-All Other Plans	$68 - $1,674	28%
UnitedHealthcare	$68 - $3,504	28%
Cigna	$81 - $2,877	33%
Meridian Hp Mcaid-All Plans	$91 - $788	37%
Molina Healthcare Mcaid	$91 - $788	37%
Multiplan/Phcs-All Plans	$203 - $3,504	83%
Health Dynamics-All Plans	$564 - $3,504	231%
Preferred Medical Claims Solution-All Plans	$634 - $3,504	260%
Three Rivers Provider Network-All Plans	$634 - $3,504	260%
Corvel-All Plans	$788	323%
Humana	$1,674	687%
Beech Street-All Plans	$3,504	1437%
Encompass-All Plans	$3,504	1437%
Healthlink-All Plans	$3,504	1437%
Hfn Epo	$3,504	1437%
Hfn Ppo Ip/Op Only-All Other Plans	$3,504	1437%
Wexford Ip/Op Only-All Plans	$3,504	1437%
Healthsmart-All Plans	$3,698	1517%

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 $2,069.
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 Sarah D Culbertson 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.