CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $2,616
Cash Discount Price: $2,783
vs. Medicare Baseline: 10.73x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Texas Childrens Hospital North Austin Campus is $2,616. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,783. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.73x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$2,783

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,616

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: $2,783 (1142%)

Insurance Median: $2,616 (1073%)

Cash: $2,783 (1142% of Medicare)

Ins. Median: $2,616 (1073% 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 1073% of the Medicare baseline (a markup of 973%). 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	$202 - $212	83%
Driscoll Children'S Health Plan Mcd	$222	91%
First Care Health Plan	$1,121 - $2,658	460%
UnitedHealthcare	$1,121 - $2,658	460%
Molina Mcd	$1,246	511%
Blue Cross Blue Shield	$1,454 - $2,616	596%
Community Health Choice	$1,466 - $2,658	601%
Community First Health Plan Mcd	$1,661	681%
Cook Children'S Health Plan	$1,661	681%
Cigna	$2,367 - $2,658	971%
Aetna	$2,658	1090%
Kelseycare	$2,699	1107%
Healthsmart	$2,907	1193%
Evolutions Healthcare	$3,115	1278%
First Health	$3,655 - $3,945	1499%
Multiplan	$3,738	1533%
Galaxy Health Network	$3,945	1618%

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 $2,783.
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 Texas Childrens Hospital North Austin Campus 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.