CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Grossmont Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,641
Cash Discount Price: $3,112
vs. Medicare Baseline: 10.83x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Grossmont Hospital is $2,641. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,112. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.83x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$3,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,641

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: $3,112 (1277%)

Insurance Median: $2,641 (1083%)

Cash: $3,112 (1277% of Medicare)

Ins. Median: $2,641 (1083% 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 1083% of the Medicare baseline (a markup of 983%). 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
Blue Cross Blue Shield	$581 - $3,112	238%
Health Net	$581 - $2,904	238%
County Medical Services	$622 - $3,319	255%
Community Health Group	$1,232	505%
Multiplan	$1,232 - $2,780	505%
UnitedHealthcare	$1,232 - $3,112	505%
Aetna	$1,411 - $3,319	579%
California Health And Wellness	$1,988	816%
Cigna	$1,992 - $2,863	817%
Molina	$2,037 - $3,319	836%
Kaiser	$2,074	851%
Blue Shield	$2,489 - $2,904	1021%
Humana	$2,489 - $2,904	1021%
Indian Health Council	$2,647	1086%
Allianz Global Assistance	$2,904	1191%
Epic Americas	$2,904 - $3,112	1191%
Managed Health Network	$2,904	1191%
Medicare (plans)	$3,112	1277%
San Diego Pace	$3,112	1277%
Medi-Cal	$3,402	1396%

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 $3,112.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72148.
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.