CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Jacksonville Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $3,402
Cash Discount Price: $7,396
vs. Medicare Baseline: 9.54x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Jacksonville Memorial Hospital is $3,402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,396. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.54x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$7,396

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,402

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: $7,396 (2075%)

Insurance Median: $3,402 (954%)

Cash: $7,396 (2075% of Medicare)

Ins. Median: $3,402 (954% 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 954% of the Medicare baseline (a markup of 854%). 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
Blue Cross Blue Shield	$278 - $7,396	78%
Coventry	$295 - $1,164	83%
Health Alliance	$295 - $5,029	83%
Humana	$295 - $6,309	83%
Medicare (plans)	$295 - $1,164	83%
Tricare	$295 - $1,348	83%
UnitedHealthcare	$309 - $5,325	87%
Medicaid / KanCare	$797	224%
Molina Healthcare	$797	224%
Healthlink	$1,155 - $6,287	324%
Corvel/Corcare	$1,960 - $2,116	550%
Illinois Workers Compensation	$2,273 - $2,413	638%
Commercial Workers Compensation	$2,293	643%
Health Alliance Mh Employee Plan	$3,402	954%
Current Health Network	$4,068 - $5,547	1141%
6 Degrees Health	$4,438	1245%
Hope Trust	$4,438	1245%
Hst	$4,438	1245%
Cigna	$5,125	1438%
Aetna	$5,170 - $5,917	1450%
Phcs/Multiplan	$6,656	1867%
Hfn	$7,026	1971%
Liability	$7,396	2075%

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 $7,396.
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 Jacksonville 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.