CMS Price Transparency Data

MRI, brain (no contrast)

Facility: St Joseph's Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $2,864
  • Cash Discount Price: $3,221
  • vs. Medicare Baseline: 11.75x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at St Joseph's Hospital is $2,864. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,221. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.75x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$3,221

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,864

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: $3,221 (1321%)
Insurance Median: $2,864 (1175%)
Cash: $3,221 (1321% of Medicare)
Ins. Median: $2,864 (1175% 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 1175% of the Medicare baseline (a markup of 1075%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Molina Healthcare $487 - $895 200%
Meridian Health Plan $510 209%
Aetna $895 - $3,127 367%
UnitedHealthcare $895 - $4,474 367%
Humana $895 367%
Sae Hospice $895 367%
Blue Cross Blue Shield $895 367%
Clear Spring Health of Illinois $895 367%
Amish Community $1,253 514%
Naphcare $1,879 771%
Cigna $1,929 791%
Celtic Insurance Company $1,969 808%
Claim Doc $2,237 918%
Hopetrust $2,237 918%
Caterpillar, Inc. $2,359 968%
Wellfirst $2,864 1175%
First Health $3,306 1356%
Healthlink $3,803 1560%
Multiplan/Phcs $3,803 1560%
Healthcare Finest Network (Hfn) $4,027 1652%
Provider Network of America $4,027 1652%
Current Health Solutions $4,474 1835%
Interplan $4,474 1835%
Mental Health Network $4,474 1835%
Consociate Group $4,474 1835%
Illinois Breast and Cervical Cancer Program $4,474 1835%
Qtc Medical Group of Illinois $4,474 1835%
Healthscope $4,474 1835%
Health Alliance Medical Plans $4,474 1835%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals