Mark Cuban Asked Why Insurance Pays $2,500 for a $350 MRI. We Checked 37.7 Million Rates.

The tweet that started this

On January 13, 2026, billionaire investor Mark Cuban posted a question on X that most people privately think but rarely say out loud: "Explain to me why the insurance company will pay $2500 for an MRI when there is a center down the street that will do it for $350?" Benzinga covered the post within hours. The replies read like a support group. One person said their insurer was billed $1,500 for a scan a cash clinic offered for $275. Another cited $3,200 versus $212 for the identical procedure.

Cuban is an investor, not a health economist, but the question is fair, and it is the exact question FairVisitHealth exists to answer with data instead of guesswork. We hold 37.7 million insurer-negotiated payment rates and more than a million hospital price-transparency filings. So instead of arguing with a tweet, we pulled the real numbers for MRI, the procedure Cuban actually asked about, and checked what our own database says.

What the real numbers show

We looked at three MRI billing codes: CPT 70551 (brain MRI, no contrast), 70552 (with contrast), and 70553 (with and without contrast, the more complete study most brain workups order). We pulled two different kinds of real pricing data for these codes.

First, hospitals' own posted self-pay prices. Under a federal price-transparency rule, every hospital must publish the cash rate it charges a patient who pays out of pocket with no insurance involved. Averaging those filings by state for CPT 70551 gives a striking range:

• Michigan: $5,309 average hospital self-pay price, from 62 reporting hospitals • Nevada: $4,518 average, from 17 hospitals • Florida: $3,798 average, from 45 hospitals • Wisconsin: $3,572 average, from 25 hospitals • California: $3,310 average, from 47 hospitals • Texas: $2,847 average, from 63 hospitals • Indiana: $902 average, from 22 hospitals • Pennsylvania: $770 average, from 16 hospitals

Same scan. Same billing code. A more than 7x difference in what a hospital says it will charge a self-pay patient, state to state, before insurance ever enters the conversation.

Second, we looked at what insurers have actually negotiated to pay for the same billing codes, across every contract line item in our database. Nationally, the median negotiated facility rate for CPT 70551 is $198.51, drawn from 4,411 separate contract lines. For the more complete 70553 study, the national median negotiated facility rate is $303.49 across 4,362 contract lines, but the full range on that single code runs from $1.00 to $17,564.48. That is not a typo. The identical five-digit billing code, submitted by different networks in different markets, produces payment amounts three orders of magnitude apart.

Here is the comparison that matters most for Cuban's question: hospitals' own self-pay price against the median rate insurers have actually negotiated for the same code, state by state.

• Texas: hospital self-pay $2,847 vs. insurer-negotiated median $179 • Michigan: hospital self-pay $5,309 vs. insurer-negotiated median $216 • California: hospital self-pay $3,310 vs. insurer-negotiated median $796 • Florida: hospital self-pay $3,798 vs. insurer-negotiated median $1,167 • Indiana: hospital self-pay $902 vs. insurer-negotiated median $203 • Nevada: hospital self-pay $4,518 vs. insurer-negotiated median $130 • Pennsylvania: hospital self-pay $770 vs. insurer-negotiated median $248

Methodology: hospital figures are the average discounted cash price reported by hospitals in our CMS-sourced price-transparency database, by state, for CPT 70551, as of July 2026. Insurer-negotiated figures are the median institutional (facility) contract rate for the same CPT code, drawn from 37.7 million negotiated-rate records in our database, as of July 2026. Both are averages and medians, not quotes for any specific patient or facility.

Why the gap runs this way, and what it actually means

Look closely at that table and something jumps out: in every state we checked, the hospital's own self-pay sticker price is higher than the median rate insurers have negotiated for that same scan nationally. That is the opposite of what Cuban's tweet implies at first read. It does not mean insurance is cheap. It means something more specific, and more useful: the "$350 down the street" scan people cite almost never happens at a hospital. It happens at a freestanding, independent imaging center, which is a different kind of business entirely.

A hospital's outpatient MRI suite carries a facility fee, round-the-clock staffing costs, general overhead, and often the pricing leverage of a large health system that dominates its local market. An independent imaging center down the street usually owns one or two machines in one building, with a fraction of the overhead, and competes almost entirely on price because that is the only lever available to it. When Cuban's replies cite $1,500 versus $275, or $3,200 versus $212, the expensive number is very likely a hospital-based bill, whether it is paid by insurance or billed self-pay. The cheap number is very likely an independent center's cash rate.

The insurance-negotiated rate itself is also not one number, and that is the second, bigger finding in our data. It is thousands of separate, privately negotiated contract lines, and the range shows why nobody outside a hospital billing office can predict which one applies to a given patient. The same CPT code, 70553, produced a negotiated payment of $1.00 in one contract and $17,564.48 in another. Neither figure is "the price" of a brain MRI. Each is the output of one negotiation between one insurer and one facility, and the patient booking the appointment has almost no way to know in advance which contract line will apply to their claim.

That opacity, more than a simple cash-versus-insurance gap, is the real mechanism behind Cuban's question. The price of an MRI in the United States is not set by what the scan costs to produce. It is set by which building a patient walks into and which contract that patient's insurer happens to have signed with that building.

What this means if you need an MRI

A few things follow directly from the data above.

First, ask whether the facility is hospital-owned before booking. If a referral defaults to "the hospital's imaging center," ask whether an independent radiology or imaging center nearby can run the same scan. It is frequently the cheaper option, insured or not, and the image quality for a standard brain, spine, or joint MRI is typically comparable.

Second, ask for the hospital's self-pay price even when insured. If a plan carries a high deductible, our data shows the hospital's own cash rate is sometimes lower than what a patient would owe toward that deductible under the insurer's negotiated rate. Compare both before scheduling, not after the bill arrives.

Third, remember that "in-network" does not mean "cheapest." An in-network hospital MRI can cost several times more than an in-network, or cash-pay, independent imaging center for the identical scan. Network status only describes what counts toward a deductible. It says nothing about the actual dollar amount.

Fourth, get a number in writing before the appointment. Ask the scheduling desk for a written, itemized estimate that separates the facility fee from the radiologist's reading fee. Federal "good faith estimate" rules give self-pay and underinsured patients the right to request this before a scan is performed.

FairVisitHealth was built for exactly this problem. Search MRI prices near you and see negotiated rates and hospital self-pay prices side by side, for a real ZIP code, before booking anything. It will not change how insurers negotiate contracts. It will show, in advance, which building is closer to the $350 scan and which is closer to the $2,500 one.

*Prices cited above are averages and medians drawn from our database as of July 2026. They are estimates, not a quote for any specific facility, insurance plan, or patient, and actual charges vary by provider, plan, and negotiated contract. This article is informational and is not medical advice.*