CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $615
Cash Discount Price: $1,397
vs. Medicare Baseline: 2.52x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Cook Childrens Medical Center Prosper is $615. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,397. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.52x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$1,397

Average discount available for prompt cash payment at this facility.

Insurance Median

$615

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,397 (573%)

Insurance Median: $615 (252%)

Cash: $1,397 (573% of Medicare)

Ins. Median: $615 (252% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 252% of the Medicare baseline (a markup of 152%). 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
United Community	$237 - $1,385	97%
Aetna	$241 - $3,181	99%
UnitedHealthcare	$282 - $3,181	116%
Beacon	$294 - $2,021	121%
El Paso Health First	$294 - $2,021	121%
Health Plan W. Uhrip	$294	121%
Health Plan W/O Uhrip	$294 - $2,021	121%
Tx Children Health	$294 - $2,021	121%
Wellpoint	$309	127%
Blue Cross Blue Shield	$318 - $3,368	130%
Superior Health	$318	130%
Firstcare	$324 - $2,994	133%
S&W Health	$538 - $3,144	221%
Cigna	$545 - $3,181	224%
Healthscope	$545 - $3,181	224%
Imagine Health	$545 - $3,181	224%
Humana	$557 - $3,294	228%
Multiplan	$557 - $3,256	228%
First Health	$564 - $3,294	231%
Galaxy Health	$577 - $3,368	237%
Healthsmart	$577 - $3,368	237%
Usamco	$589 - $3,443	242%

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 $1,397.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cook Childrens Medical Center Prosper is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70551.
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.