CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: PAM Rehabilitation Hospital of Allen

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $8,017
Cash Discount Price: $10,689
vs. Medicare Baseline: 22.49x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at PAM Rehabilitation Hospital of Allen is $8,017. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,689. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 22.49x the Medicare baseline. Located in 1001 Raintree Circle, Allen, TX.

Cash / Self-Pay

$10,689

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,017

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: $10,689 (2999%)

Insurance Median: $8,017 (2249%)

Cash: $10,689 (2999% of Medicare)

Ins. Median: $8,017 (2249% 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 2249% of the Medicare baseline (a markup of 2149%). 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 Health	$333	93%
Wellpoint (Amerigroup)	$333	93%
America'S Choice Provider Network	$7,483	2099%
Provider Network Of America	$8,017	2249%
Quik Trip	$8,017	2249%
Usa Managed Care Organization	$8,017	2249%
Velocity Provider Ppo Network	$8,017	2249%
Multiplan/Phcs	$8,551	2399%
Prime Health Services	$9,086	2549%
Medincrease	$9,620	2699%

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 $10,689.
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 PAM Rehabilitation Hospital of Allen 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.