CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Matagorda Regional Medical Center

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,547
Cash Discount Price: $1,382
vs. Medicare Baseline: 4.34x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Matagorda Regional Medical Center is $1,547. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,382. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.34x the Medicare baseline. Located in 104 7Th Street, Bay City, TX.

Cash / Self-Pay

$1,382

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,547

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: $1,382 (388%)

Insurance Median: $1,547 (434%)

Cash: $1,382 (388% of Medicare)

Ins. Median: $1,547 (434% 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 434% of the Medicare baseline (a markup of 334%). 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
Aetna	$354 - $1,732	99%
Humana	$354 - $788	99%
Medicare (plans)	$354	99%
Triwest	$354	99%
United	$354	99%
Wellcare	$354	99%
UnitedHealthcare	$390 - $1,547	109%
Am Better	$425	119%
Alliance	$496	139%
Cigna	$700	196%
Corvel	$708	199%
Coventry First Health	$750	210%
Comm Care	$1,547	434%
Medicaid / KanCare	$1,547	434%
Molina	$1,547	434%
Scott & White	$1,547	434%
Superior	$1,547	434%
Tcstar	$1,547	434%
Wellpoint	$1,547	434%
Blue Cross Blue Shield	$1,689 - $2,378	474%
Galaxy Health	$1,934	543%
Independent Medical System	$2,349	659%
Multiplan Phcs	$2,349	659%
Three Rivers	$2,349	659%
Health Smart	$2,487	698%
Usa Managed	$2,487	698%

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 $1,382.
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 Matagorda 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.