CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: HCA Houston Healthcare West

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,706
Cash Discount Price: $25,098
vs. Medicare Baseline: 4.79x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at HCA Houston Healthcare West is $1,706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,098. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.79x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.

Cash / Self-Pay

$25,098

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,706

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: $25,098 (7041%)

Insurance Median: $1,706 (479%)

Cash: $25,098 (7041% of Medicare)

Ins. Median: $1,706 (479% 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 479% of the Medicare baseline (a markup of 379%). 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
Texas Health Network	$322	90%
Amerigroup	$328	92%
Texas Childrens Health Plans	$328 - $4,166	92%
Community Health Choice Mcd	$333	93%
United	$339 - $11,294	95%
Aetna	$359 - $2,168	101%
Molina Healthcare	$361	101%
Humana	$410 - $4,633	115%
Blue Cross Blue Shield	$764 - $8,784	214%
Superior Health Plan	$1,506	423%
Cigna	$2,127 - $20,078	597%
Texas Workforce Commission	$6,024	1690%
Christus (Usfhp)	$10,039	2817%
Healthsmart Preferred Care	$10,792 - $21,333	3028%
Fidelis Securecare Of Tx	$11,294	3169%
Coventry National First Health	$13,377	3753%
Physicians Cooperative Of Texas	$13,804	3873%
Rockport Workers Comp	$13,804	3873%
Independent Medical System	$15,059	4225%
National Healthcare Solutions	$15,059	4225%
Southwest Medical	$15,059	4225%
Triumph	$15,059	4225%
Coastal Comp	$16,314	4577%
Multiplan	$18,824 - $21,333	5281%
Physicians, Inc	$21,333	5985%
Affiliated Ppo	$22,588	6337%

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 $25,098.
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 HCA Houston Healthcare West 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.