Prior authorization update
Most MRIs no longer need prior authorization
Effective Friday, September 18, 2026 · All Curative plans
From September 18, Curative members can get an MRI at nearly any in-network facility without prior authorization. The requirement remains at 41 hospital facilities where a single scan costs 5-20x the market rate and is not cost-effective, given that scans of the same quality are available at other in-network facilities at a fraction of the cost. Those facilities requiring prior authorization are listed below, with their average cost. Our goal is to remove as much friction from our members’ access to care as possible, and demonstrate through transparency why these remaining facilities are not cost-effective and continue to need prior authorization.
What an MRI costs
Most scans are inexpensive. The mean sits far above the typical scan, because a small number of scans cost thousands of dollars each.
Median MRI
$445
Half of all MRIs cost less than this
Average MRI
$902
Twice the median, lifted by a small number of high-cost scans
Freestanding & office
$319
Median at an imaging center — 68% of all our MRIs
Hospital outpatient
$1,472
Median for the same scans in a hospital
Seven in ten MRIs cost less than $750. Scans above $2,000 are 13% of the volume and almost half of the spend. That is the part of the picture we have kept under review.
Most MRIs are inexpensive. A few are not.
Share of the 7,334 MRIs performed in TX, FL and GA, September 2025 – August 2026, by total allowed amount per scan (facility and radiologist combined).
View as table
| Cost of the scan | MRIs | % of MRIs | % of spend |
|---|---|---|---|
| Under $250 | 2,060 | 28.1% | 4.7% |
| $250 – $500 | 1,865 | 25.4% | 10.2% |
| $500 – $750 | 1,261 | 17.2% | 11.3% |
| $750 – $1,000 | 269 | 3.7% | 3.4% |
| $1,000 – $1,500 | 150 | 2.0% | 2.7% |
| $1,500 – $2,000 | 788 | 10.7% | 19.4% |
| $2,000 – $3,000 | 410 | 5.6% | 15.6% |
| $3,000 – $4,000 | 336 | 4.6% | 18.6% |
| $4,000 and above | 195 | 2.7% | 14.3% |
The same scan, a very different price. A brain MRI with and without contrast (CPT 70553) has a median allowed amount of $550 at an imaging center and $1,162 in a hospital outpatient department — and above $3,700 at several of the hospitals listed below. The scan itself is the same.
What is changing
- No prior authorization for MRI at any in-network facility that is not on the list below.
- Emergency and inpatient MRIs never require prior authorization, at any facility, including the facilities on this list.
- At the 41 listed facilities, scheduled outpatient MRI continues to require prior authorization, with the same submission process and turnaround times as today.
Where prior authorization still applies
These 41 facilities averaged $3,067 per MRI over the last twelve months. Everywhere else in our network averaged $684.
Providers exempt from preauthorization don’t need prior authorization, even at a listed facility
A Curative preauthorization exemption (aka “gold card”) for an MRI service applies at listed facilities too.
How a facility gets on this list
A facility is listed if its average allowed amount per MRI exceeded $2,000 over the trailing twelve months (roughly four and a half times the network median) across at least four Curative MRIs. Hospital campuses that bill under the same contract as a listed facility are listed with it.
| Facility | City | State | NPI | TIN | Average per MRI |
|---|---|---|---|---|---|
| Baylor Scott & White HealthSystem average $2,820 per MRI. Listed campuses only. All other Baylor Scott & White locations are exempt from prior authorization. | |||||
| Baylor Scott & White Texas Spine & Joint Hospital | Tyler | TX | 1942292255 | 752951355 | $5,830 |
| Baylor Orthopedic and Spine Hospital at Arlington | Arlington | TX | 1346570710 | 261578178 | $3,340 |
| Baylor All Saints Medical Center | Fort Worth | TX | 1669472387 | 751008430 | $3,170 |
| Baylor University Medical Center | Dallas | TX | 1447250253 | 751837454 | $3,170 |
| Baylor Scott & White Medical Center – Austin | Austin | TX | 1902366305 | 813040663 | $3,050 |
| Baylor Scott & White Medical Center – Pflugerville | Pflugerville | TX | 1346729159 | 813040663 | $3,000 |
| Baylor Scott & White Medical Center – Irving | Irving | TX | 1992700983 | 752586857 | $2,960 |
| Baylor Scott & White Buda Hospital | Buda | TX | 1144781501 | 813040663 | $2,920 |
| Baylor Scott & White Hillcrest Medical Center | Waco | TX | 1891882833 | 741161944 | $2,900 |
| Baylor Scott & White Medical Center – Plano | Plano | TX | 1649273434 | 412101361, 820551704 | $2,830 |
| Baylor Scott & White Medical Center – Round Rock | Round Rock | TX | 1265568638 | 203749695, 741166904 | $2,830 |
| Baylor Scott & White Medical Center – College Station | College Station | TX | 1265772362 | 274434451 | $2,830 |
| Baylor Scott & White Medical Center – Temple | Temple | TX | 1477516466 | 741166901, 741166904 | $2,710 |
| Baylor Scott & White Medical Center – Marble Falls | Marble Falls | TX | 1396138970 | 464007700 | $2,700 |
| Baylor Scott & White Medical Center – Centennial | Frisco | TX | 1801826839 | 824052186 | $2,550 |
| Baylor Scott & White Clinic – Waco | Waco | TX | 1093779704 | 464007700+14 more741161944, 741166904, 742358277, 742368277, 742858277, 742952277, 742953277, 742955277, 742956277, 742958227, 742958277, 742959277, 742988277, 742998277 | $2,510 |
| Baylor Scott & White Medical Center – Grapevine | Grapevine | TX | 1073511762 | 751777119 | $2,490 |
| Baylor Scott & White Medical Center – Waxahachie | Waxahachie | TX | 1265430177 | 741166904, 751844139 | $2,470 |
| Baylor Scott & White The Heart Hospital – McKinney | McKinney | TX | 1962504340 | 263603862, 412101361 | $2,210 |
| Baylor Scott & White Medical Center – Lake Pointe | Rowlett | TX | 1205018439 | 260194016, 752586857 | $2,020 |
| Baylor Scott & White Medical Center – Frisco | Frisco | TX | 1922002674 | 752865177 | $2,820 † |
| Baylor Scott & White Medical Center – Frisco at PGA Parkway | Frisco | TX | 1851108765 | 751037591, 751049190 | $2,820 † |
| Baylor Scott & White Medical Center – McKinney | McKinney | TX | 1124305065 | 751037591 | $2,820 † |
| Baylor Scott & White Medical Center – Sunnyvale | Sunnyvale | TX | 1255579389 | 510570864 | $2,820 † |
| Baylor Scott & White Surgical Hospital – Fort Worth | Fort Worth | TX | 1871599183 | 752658178 | $2,820 † |
| AdventHealth — Central Florida campusesListed campuses only. All other AdventHealth locations are exempt from prior authorization. | |||||
| AdventHealth Palm Coast | Palm Coast | FL | 1679678486 | 592951990 | $3,510 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | FL | 1871977942 | 473793197 | $3,240 |
| AdventHealth Fish Memorial | Orange City | FL | 1700978558 | 593149293 | $2,950 |
| AdventHealth Daytona Beach | Daytona Beach | FL | 1063426823 | 590973502 | $2,710 |
| AdventHealth DeLand | DeLand | FL | 1649367269 | 593256803 | $2,390 |
| AdventHealth Orlando | Orlando | FL | 1306938071 | 590724459 | $2,190 |
| CHRISTUS HealthListed campuses only. All other CHRISTUS locations are exempt from prior authorization. | |||||
| CHRISTUS Santa Rosa Hospital – Westover Hills | San Antonio | TX | 1194787218 | 741109665 | $4,380 |
| CHRISTUS Santa Rosa Hospital – New Braunfels | New Braunfels | TX | 1780867390 | 741109665 | $3,550 |
| CHRISTUS Spohn Hospital Corpus Christi – South | Corpus Christi | TX | 1689641680 | 741109836 | $2,850 |
| Academic and specialty hospitals | |||||
| Nicklaus Children's Hospital | Miami | FL | 1871540237 | 590638499 | $5,500 |
| H. Lee Moffitt Cancer Center | Tampa | FL | 1780653618 | 593238634 | $4,970 |
| The University of Texas MD Anderson Cancer Center | Houston | TX | 1174582050 | 746001118 | $4,730 |
| University of Miami Hospital and Clinics | Miami | FL | 1679660617 | 592616017 | $3,840 |
| UT Health Tyler Regional Hospital | Tyler | TX | 1407364847 | 823878395 | $3,210 |
| Other hospitals | |||||
| Freestone Medical Center | Fairfield | TX | 1235685892 | 741774669 | $2,620 |
| North Central Surgical Center | Dallas | TX | 1548236524 | 201508140 | $2,050 |
† Campus covered by the Baylor Scott & White system contract. Curative paid fewer than four MRIs at this campus in the measurement window, so the system average is shown rather than a campus figure.
Averages are what Curative actually paid per scan, including cases where more than one body part was imaged on the same day.
TIN lists every tax identification number Curative has on record billing under that NPI. A facility may bill under more than one, and the same TIN may appear against more than one facility, so a TIN alone does not determine whether prior authorization applies — the NPI does.
What this means for you
If you are a member
You do not need to do anything, and in almost every case you will not notice a review at all.
- Your doctor orders the MRI; you schedule it. No authorization number, no waiting on us.
- If your doctor sends you to one of the 41 listed facilities, we will still review it. Your Care Navigator can also help you find an in-network alternative nearby that needs no review.
- Emergency imaging never needs authorization.
If you are a provider
Order the study your patient needs and send it where it is clinically right.
- No authorization request, no peer-to-peer and no external review for MRI at in-network facilities that are not on the list.
- For the listed facilities, submit as you do today. Standard and expedited timelines are unchanged.
- Emergency MRIs are exempt everywhere.
How the list is maintained
- No facility is newly subject to prior authorization on September 18. MRI required authorization across the network before this change; the change removes it everywhere except the facilities listed above.
- Reviewed every quarter against the trailing twelve months of paid claims. The next review is January 2027.
- A facility comes off the list automatically once its average falls below the threshold, most often after a contract is renegotiated. It does not have to ask.