CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,493
Cash Discount Price: $3,026
vs. Medicare Baseline: 4.19x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Cook Childrens Medical Center Prosper is $1,493. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,026. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.19x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$3,026

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,493

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: $3,026 (849%)

Insurance Median: $1,493 (419%)

Cash: $3,026 (849% of Medicare)

Ins. Median: $1,493 (419% 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 419% of the Medicare baseline (a markup of 319%). 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
Aetna	$394 - $3,429	111%
Beacon	$464 - $2,179	130%
El Paso Health First	$464 - $2,179	130%
Health Plan W. Uhrip	$464	130%
Health Plan W/O Uhrip	$464 - $2,179	130%
Tx Children Health	$464 - $2,179	130%
Wellpoint	$487	137%
Blue Cross Blue Shield	$501 - $3,631	141%
Superior Health	$501	141%
Firstcare	$511 - $3,228	143%
United Community	$511 - $1,493	143%
UnitedHealthcare	$1,775 - $3,429	498%
S&W Health	$3,389	951%
Cigna	$3,429	962%
Healthscope	$3,429	962%
Imagine Health	$3,429	962%
Humana	$3,510 - $3,550	985%
Multiplan	$3,510	985%
First Health	$3,550	996%
Galaxy Health	$3,631	1019%
Healthsmart	$3,631	1019%
Usamco	$3,712	1041%

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 $3,026.
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 Cook Childrens Medical Center Prosper 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.