CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,211
Cash Discount Price: $2,805
vs. Medicare Baseline: 6.20x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Sarah D Culbertson Memorial Hospital is $2,211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,805. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.20x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$2,805

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,211

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: $2,805 (787%)

Insurance Median: $2,211 (620%)

Cash: $2,805 (787% of Medicare)

Ins. Median: $2,211 (620% 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 620% of the Medicare baseline (a markup of 520%). 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	$105 - $4,628	29%
Blue Cross Blue Shield	$105 - $5,039	29%
Molina Mmai-All Other Plans	$105 - $2,211	29%
UnitedHealthcare	$105 - $4,628	29%
Cigna	$126 - $3,800	35%
Meridian Hp Mcaid-All Plans	$297 - $1,329	83%
Molina Healthcare Mcaid	$297 - $1,329	83%
Multiplan/Phcs-All Plans	$316 - $4,628	89%
Health Dynamics-All Plans	$873 - $4,628	245%
Preferred Medical Claims Solution-All Plans	$982 - $4,628	276%
Three Rivers Provider Network-All Plans	$982 - $4,628	276%
Corvel-All Plans	$1,329	373%
Humana	$2,211	620%
Beech Street-All Plans	$4,628	1298%
Encompass-All Plans	$4,628	1298%
Healthlink-All Plans	$4,628	1298%
Hfn Epo	$4,628	1298%
Hfn Ppo Ip/Op Only-All Other Plans	$4,628	1298%
Wexford Ip/Op Only-All Plans	$4,628	1298%
Healthsmart-All Plans	$4,885	1371%

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 $2,805.
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 Sarah D Culbertson 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.