CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Banner Payson Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $737
  • Cash Discount Price: $812
  • vs. Medicare Baseline: 3.02x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Banner Payson Medical Center is $737. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $812. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.02x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$812

Average discount available for prompt cash payment at this facility.

Insurance Median
$737

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $812 (333%)
Insurance Median: $737 (302%)
Cash: $812 (333% of Medicare)
Ins. Median: $737 (302% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 302% of the Medicare baseline (a markup of 202%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Arizona Physicians Ipa $167 - $671 69%
Banner University Health Plan $167 - $671 69%
Health Choice Arizona, Inc. $167 - $958 69%
Health Net $167 - $993 69%
Mercy Care $167 - $671 69%
Aetna $487 - $1,084 200%
Banner Health $671 275%
Blue Cross Blue Shield $671 - $932 275%
Care 1St $671 275%
Cigna $671 - $1,303 275%
Gila River Health Care Corporation $671 275%
Kaiser Foundation Health Plan $671 275%
Triwest Healthcare Alliance Corp - Va Ccn $671 275%
UnitedHealthcare $671 - $1,097 275%
Upmc Health Plan $671 275%
Wellpoint $671 275%
Carelon $705 289%
Humana $711 292%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $737 302%
Plotkin Health $737 302%
Arizona Priority Care $738 303%
Devoted Health Services $738 303%
Gold Kidney Health Plan $738 303%
Oscar Health Plan $1,107 454%
Quiktrip Corporation $1,146 470%
Arizona Medical Network $1,473 604%
Provider Network Of America $1,473 604%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals