CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Guadalupe Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $470
Cash Discount Price: $1,264
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Guadalupe Regional Medical Center is $470. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,264. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.32x the Medicare baseline. Located in 1215 E Court St, Seguin, TX.

Cash / Self-Pay

$1,264

Average discount available for prompt cash payment at this facility.

Insurance Median

$470

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: $1,264 (355%)

Insurance Median: $470 (132%)

Cash: $1,264 (355% of Medicare)

Ins. Median: $470 (132% 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.

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
Superior Hlth Plan Mmcd	$249 - $2,108	70%
Aetna	$299 - $3,981	84%
Christus Exchange Health Plan	$299 - $366	84%
Mcr Clover Health	$299 - $366	84%
Mcr Texas Independence Health	$299 - $366	84%
Mcr Wellcare	$299 - $366	84%
Oscar Health Plan	$299 - $366	84%
Va Triwest Health Alliance	$299 - $366	84%
Healthcare Highways	$415 - $3,513	116%
UnitedHealthcare	$415 - $3,513	116%
Humana	$470 - $3,981	132%
Cigna	$498 - $4,216	140%
Texas Mutual Insurance Co	$498 - $4,216	140%
Blue Cross Blue Shield	$2,464 - $2,738	691%

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 $1,264.
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 Guadalupe Regional Medical Center 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.