CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Texas Childrens Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $4,173
Cash Discount Price: $4,438
vs. Medicare Baseline: 11.71x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Texas Childrens Hospital is $4,173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,438. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.71x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$4,438

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,173

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: $4,438 (1245%)

Insurance Median: $4,173 (1171%)

Cash: $4,438 (1245% of Medicare)

Ins. Median: $4,173 (1171% 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 1171% of the Medicare baseline (a markup of 1071%). 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
Superior Chip	$328 - $345	92%
Driscoll Children'S Health Plan Mcd	$361	101%
First Care Health Plan	$1,788 - $4,239	502%
UnitedHealthcare	$1,788 - $4,239	502%
Molina Mcd	$1,987	557%
Blue Cross Blue Shield	$2,318 - $4,173	650%
Community Health Choice	$2,338 - $4,239	656%
Community First Health Plan Mcd	$2,650	743%
Cook Children'S Health Plan	$2,650	743%
Cigna	$3,776 - $4,239	1059%
Aetna	$4,239	1189%
Kelseycare	$4,306	1208%
Healthsmart	$4,637	1301%
Evolutions Healthcare	$4,968	1394%
First Health	$5,829 - $6,293	1635%
Multiplan	$5,962	1673%
Galaxy Health Network	$6,293	1766%

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 $4,438.
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 Texas Childrens 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.