Compare CT scan costs in Texas. Medicare: $147–$152 (OPPS wage-adjusted $109–$113 + professional $38–$39). Commercial: $323–$532. Cash: $588–$912. Medicaid: $110–$114. Wage-adjusted hospital outpatient rates.
CT Scan Cost in Texas: Medicare, Insurance & Cash (2026)
CT scan costs in Texas vary by facility type, insurance coverage, and geographic adjustments. Below is a data-driven comparison based on 2026 Medicare hospital outpatient rates (OPPS technical + PFS professional) and estimated commercial and cash pricing for Texas procedures.
Want to understand CT scan pricing more broadly? See CT scan pricing explained.
Texas CT Scan Cost Summary (2026 - Wage-Adjusted)
| Payer Type | Cost |
|---|---|
| Medicare Technical (OPPS) | $109–$113* |
| Medicare Professional (PFS-26) | $38–$39 |
| Medicare Total | $147–$152 |
| Commercial (In-Network) | $323–$532 |
| Cash/Uninsured | $588–$912 |
| Medicaid (Estimated) | $110–$114 |
*Adjusted for geographic wage index (varies by state/CBSA labor costs)
Note: Prices are for the primary procedure only (CPT 70450: CT head/brain without contrast). Additional charges listed below may apply.
⚠️ Pricing Can Vary Significantly: Hospital outpatient settings typically charge more than independent imaging centers for the same procedure. Always request a detailed quote and compare facilities.
How Medicare Pays for Hospital Outpatient CT Scans
Medicare pays for hospital outpatient CT scans using a two-component payment model (see summary above):
Technical Component (OPPS): Hospital facility costs
- Covers: imaging equipment, technician labor, facility overhead, image capture and processing
- Adjusted for geographic wage index (varies by state/CBSA labor costs)
Professional Component (PFS-26): Radiologist services
- Covers: radiologist interpretation, report generation, quality assurance
Important: The Medicare total shown above ($147–$152 for Texas) represents the actual hospital outpatient imaging payment. If a facility bills more than this to cash-pay or commercial patients, that difference reflects facility markup or chargemaster pricing.
Understanding CT Scan Pricing by Facility Type
Medicare rates vary based on where the imaging is performed:
Hospital Outpatient Department: Uses the OPPS payment schedule (technical $109–$113 + professional $38–$39 = $147–$152, wage-adjusted)
- Higher facility charges; includes hospital overhead; adjusted for geographic labor costs
Independent Imaging Center: Uses PFS non-facility rates (often lower)
- Lower facility charges; may be 20–40% less than hospital
Physician's Office: Uses PFS office-based rates (typically lowest)
- Lowest facility overhead; usually only available for routine imaging
💡 Cost Savings Tip: If your doctor orders a routine diagnostic CT and it's not emergent, ask if it can be done at an independent imaging center rather than a hospital. You may save $30–$50+ on facility charges.
Why CT Scan Costs Vary by State
Medicare adjusts OPPS technical payments using a geographic wage index that reflects regional labor costs. Texas (South region) has a regional multiplier of 2.2–3.5× for commercial insurance, compared to other regions:
Comparing CT scan costs across all 50 states? See CT scan costs by state.
- Northeast (NY, MA, CT, etc.): 2.5–4.0× (higher labor costs)
- South (TX, FL, GA, etc.): 2.2–3.5× (moderate labor costs)
- Midwest (IL, OH, MI, etc.): 2.3–3.8× (moderate labor costs)
- West (CA, WA, CO, etc.): 2.4–4.0× (variable labor costs)
What Additional Charges Might Be Added?
The $147–$912 range above represents the imaging procedure itself. Depending on your circumstances, you may face additional charges for:
- Radiologist Interpretation: Usually included in the professional component, but some practices bill separately ($50–$150)
- Contrast Upgrade: If IV or oral contrast is required (+$50–$150 depending on type)
- Facility Fee (Hospital): Hospitals may bill higher commercial facility charges than Medicare OPPS rates
- Emergency Department Surcharge: If the scan is performed during an ER visit (+$500–$1,500 ED charge)
- Follow-Up Imaging: If the radiologist recommends additional imaging
- 3D Reconstruction: Advanced imaging post-processing (+$50–$200)
💡 Best Practice: Before scheduling a CT scan, ask the facility for a written quote that breaks down:
- Imaging procedure charge (CPT code, typically 70450)
- Any additional facility fees
- Contrast costs (if applicable)
- Radiologist interpretation fee (if billed separately)
CT Scan Cost by Insurance Type in Texas (2026)
| Insurance Type | Estimated Cost | Your Out-of-Pocket (Typical) | Notes |
|---|---|---|---|
| Medicare FFS | $147–$152 (109–113 + 38–39, wage-adjusted) | $0–$20 (after deductible) | ✅ Observed: OPPS technical (wage-adjusted) + PFS-26 professional |
| Medicare Advantage (MA) | $147–$152 base + plan copay | $35–$500 (plan-dependent) | ⚠️ Copay varies by plan and facility type |
| Commercial Insurance | $323–$532 | $0–$250 (after deductible + copay) | ✅ Estimated: 2.2–3.5× Medicare multiplier (South region, wage-adjusted) |
| Medicaid | $110–$114 | $0–$5 (plan-dependent) | ⚠️ Modeled: 75% of Medicare (varies by MCO) |
| Uninsured/Cash | $588–$912 | $588–$912 (full charge) | May negotiate 20–50% discount if paid upfront |
Frequently Asked Questions About CT Scan Costs in Texas
Why does Medicare have two components (technical and professional)?
Medicare separates technical and professional components to allow different payment for different settings. Hospital outpatient departments have higher facility overhead, so they receive a higher technical component. Independent imaging centers receive lower technical fees but the same professional fee.
Does insurance cover a CT scan?
Most health plans cover medically necessary CT scans after deductibles and subject to authorization requirements. Contact your insurance company before scheduling to verify coverage and your estimated out-of-pocket cost.
Why do hospital CT scans cost more than imaging center scans?
Hospital outpatient departments have higher operational costs (staffing, equipment, facility maintenance) than independent imaging centers. Medicare pays hospitals more for the same procedure through higher OPPS technical rates. If your doctor orders a routine diagnostic CT, an independent imaging center may save you 20–40%.
Can I negotiate the CT scan price?
Yes. Most hospitals and imaging centers offer cash-pay discounts of 20–50% if you pay upfront before the scan. Request an itemized quote from 2–3 facilities and compare.
What if I need contrast dye?
If contrast is required, add $50–$150 to the imaging cost depending on contrast type and volume. The CPT code will differ (e.g., 70450 without contrast vs. 70460 with contrast), and Medicare rates differ accordingly.
How do Medicare Advantage plans price CT scans?
MA plans typically follow Medicare pricing for in-network providers but charge a plan copay (e.g., $35–$500 depending on the plan and facility). Review your plan's benefits or call the plan to confirm your copay before scheduling.
Methodology & Data Transparency
Data Sources
Medicare Hospital Outpatient (OPPS + PFS):
- CMS Hospital Outpatient Prospective Payment System (OPPS) — Official national payment rates for CPT codes
- CMS Medicare Physician Fee Schedule (PFS) — Professional component rates for radiologist interpretation
- CMS OPPS Wage Index Data — Geographic adjustment factors by state/CBSA
Commercial Insurance:
- RAND Health Insurance Study methodology for regional multipliers
- Regional benchmarks applied to Medicare baseline (South region: 2.2–3.5× multiplier)
Medicaid & Cash:
- CMS Medicaid rates (modeled at 75% of Medicare for Texas)
- Medicare Outpatient Public Use File — Hospital chargemaster analysis (4–6× multiplier)
Calculation Methodology
Medicare Baseline (Wage-Adjusted):
Technical Component (OPPS) × Wage Index + Professional Component (PFS-26)
- CPT Code: 70450 (CT head/brain without contrast)
- Technical Component: Based on CMS OPPS national rates, adjusted by geographic wage index
- Wage Index: Texas CBSA wage indices range approximately 0.85–1.15. Prices shown represent statewide blended average.
- Professional Component: CMS PFS -26 modifier (radiologist interpretation)
- Result: $147–$152 Medicare total for Texas hospital outpatient CT scan
Derived Values (Commercial, Medicaid, Cash):
- Commercial = Medicare baseline × regional multiplier (2.2–3.5× for South)
- Medicaid = Medicare baseline × 75%
- Cash = Medicare baseline × chargemaster multiplier (4–6×)
Important Limitations
- These are estimates based on national data and CMS benchmarks. Actual facility pricing varies significantly.
- Prices do NOT include additional charges (contrast, facility fees, emergency surcharges).
- Commercial multipliers are regional averages and may not reflect your specific insurance plan's negotiated rates.
- Medicaid rates are modeled and vary by state program and MCO. Contact your state Medicaid agency for official rates.
- Cash prices are negotiable. Always request an itemized quote and compare at least 2–3 facilities.
Data Last Updated: February 24, 2026 | Calculation Method: OPPS National (CMS Addendum B) × Wage Index (S-3 PUF) + PFS Professional | Wage Index Applied: Yes (geographic adjustment by state/CBSA)
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