CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: PAM Specialty Hospital of San Antonio

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $7,640
Cash Discount Price: $10,186
vs. Medicare Baseline: 21.43x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at PAM Specialty Hospital of San Antonio is $7,640. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,186. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 21.43x the Medicare baseline. Located in 5418 N Loop 1604 W, San Antonio, TX.

Cash / Self-Pay

$10,186

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,640

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: $10,186 (2858%)

Insurance Median: $7,640 (2143%)

Cash: $10,186 (2858% of Medicare)

Ins. Median: $7,640 (2143% 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 2143% of the Medicare baseline (a markup of 2043%). 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
Oscar	$400	112%
Community First Health Plan	$875	245%
America'S Choice	$7,130	2000%
Provider Network Of America	$7,640	2143%
Quik Trip	$7,640	2143%
Usa Managed Care Organization	$7,640	2143%
Velocity Provider Ppo Network	$7,640	2143%
Evolutions Healthcare System	$8,149	2286%
Multiplan/Phcs	$8,149	2286%
Fortified Provider Network	$8,658	2429%
Prime Health Services	$8,658	2429%
Medincrease	$9,168	2572%

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 $10,186.
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 PAM Specialty Hospital of San Antonio 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.