CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,825
Cash Discount Price: $3,675
vs. Medicare Baseline: 5.12x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Baylor Scott & White Medical Center Pflugerville is $1,825. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,675. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.12x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$3,675

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,825

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: $3,675 (1031%)

Insurance Median: $1,825 (512%)

Cash: $3,675 (1031% of Medicare)

Ins. Median: $1,825 (512% 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 512% of the Medicare baseline (a markup of 412%). 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
Baylor Scott & White Health Plan	$327 - $1,855	92%
Superior Health Plan	$333 - $344	93%
Humana	$344 - $4,288	97%
Triwest	$344	97%
Corvel	$360	101%
Prime Health Services	$360	101%
American Health Plan	$361	101%
Healthspring	$361	101%
Procare Advantage	$361	101%
UnitedHealthcare	$396 - $2,400	111%
Sedgwick	$514	144%
Blue Cross Blue Shield	$1,497 - $1,825	420%
Cigna	$1,711 - $2,013	480%
University Of Mary Hardin-Baylor	$2,014	565%
Aetna	$3,369	945%
Midcoast	$3,369	945%
Quiktrip	$3,369	945%
Independent Medical System	$3,675	1031%
Curative	$3,982	1117%
First Health	$4,288	1203%
Healthsmart	$4,288 - $4,594	1203%
Private Health Care System	$4,594	1289%
Three Rivers	$5,513	1547%

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 $3,675.
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 Baylor Scott & White Medical Center Pflugerville 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.