CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Rush Memorial Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,345
Cash Discount Price: $1,846
vs. Medicare Baseline: 3.77x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Rush Memorial Hospital is $1,345. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,846. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.77x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$1,846

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,345

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: $1,846 (518%)

Insurance Median: $1,345 (377%)

Cash: $1,846 (518% of Medicare)

Ins. Median: $1,345 (377% 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 377% of the Medicare baseline (a markup of 277%). 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
UnitedHealthcare	$88 - $3,560	25%
Caresource Mcr Adv	$101 - $1,379	28%
Humana	$101 - $4,094	28%
Aetna	$102 - $4,094	29%
Blue Cross Blue Shield	$104 - $2,345	29%
Today'S Option Mcr Adv-All Plans	$104 - $1,421	29%
Viant Beech St Mcr Adv	$104 - $1,421	29%
My True Advantage - All Plans	$106 - $1,379	30%
Consumers Life Ins-All Plans	$110 - $4,005	31%
Caresource Marketplace-All Other Plans	$136 - $2,207	38%
Multiplan-All Plans	$141 - $4,138	40%
Encore Health Services-All Plans	$176 - $4,361	49%
Siho-All Plans	$176 - $4,094	49%
Cigna	$236 - $1,388	66%
Health Net	$236 - $1,310	66%
Phcs-All Plans	$263 - $3,560	74%
Coventry/First Health-All Plans	$331 - $4,005	93%
Sagamore-All Plans	$4,094	1149%
Community Health Alliance-All Plans	$4,183	1174%

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 $1,846.
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 Rush 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.