CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Northwest Hills Surgical Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $358
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Northwest Hills Surgical Hospital is $358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.00x the Medicare baseline. Located in 6818 Austin Ctr Blvd Suite 100, Austin, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$358

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%)

Insurance Median: $358 (100%)

Ins. Median: $358 (100% 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
Champva	$274 - $366	77%
Ambetter / Centene	$333 - $356	93%
Blue Cross Blue Shield	$333 - $1,707	93%
Wellpoint Chip/Chip Perinate	$333 - $356	93%
Wellpoint Star Kids	$333	93%
Wellpoint Star Plus	$333 - $358	93%
Dell Chip/Chip Perinate	$356 - $358	100%
Dell Star	$356 - $358	100%
UnitedHealthcare	$356 - $358	100%
Wellpoint Star	$356 - $358	100%
Humana	$436	122%
Tricare	$439	123%
Seton Performance Plus	$1,274	357%
Cigna	$1,750	491%
Aetna	$1,969 - $3,085	552%
Covenant Health	$2,378	667%

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 $X.
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 Northwest Hills Surgical 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.