CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: St Joseph's Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70553
  • Insurance Median: $4,022
  • Cash Discount Price: $4,523
  • vs. Medicare Baseline: 11.28x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at St Joseph's Hospital is $4,022. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,523. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.28x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$4,523

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,022

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: $4,523 (1269%)
Insurance Median: $4,022 (1128%)
Cash: $4,523 (1269% of Medicare)
Ins. Median: $4,022 (1128% 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 1128% of the Medicare baseline (a markup of 1028%). 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 $821 - $1,256 230%
Meridian Health Plan $860 241%
Clear Spring Health of Illinois $1,256 352%
Blue Cross Blue Shield $1,256 352%
Aetna $1,256 - $4,391 352%
Humana $1,256 352%
Sae Hospice $1,256 352%
UnitedHealthcare $1,256 - $6,282 352%
Amish Community $1,759 494%
Cigna $1,929 541%
Caterpillar, Inc. $2,359 662%
Naphcare $2,638 740%
Celtic Insurance Company $2,764 775%
Hopetrust $3,141 881%
Claim Doc $3,141 881%
Wellfirst $4,022 1128%
First Health $4,642 1302%
Multiplan/Phcs $5,340 1498%
Healthlink $5,340 1498%
Healthcare Finest Network (Hfn) $5,654 1586%
Provider Network of America $5,654 1586%
Consociate Group $6,282 1762%
Mental Health Network $6,282 1762%
Qtc Medical Group of Illinois $6,282 1762%
Health Alliance Medical Plans $6,282 1762%
Illinois Breast and Cervical Cancer Program $6,282 1762%
Current Health Solutions $6,282 1762%
Healthscope $6,282 1762%
Interplan $6,282 1762%

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