CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Valley Presbyterian Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $957
Cash Discount Price: $3,978
vs. Medicare Baseline: 3.93x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Valley Presbyterian Hospital is $957. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,978. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.93x the Medicare baseline. Located in 15107 Vanowen St, Van Nuys, CA.

Cash / Self-Pay

$3,978

Average discount available for prompt cash payment at this facility.

Insurance Median

$957

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: $3,978 (1632%)

Insurance Median: $957 (393%)

Cash: $3,978 (1632% of Medicare)

Ins. Median: $957 (393% 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 393% of the Medicare baseline (a markup of 293%). 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 Shield Senior	$301	123%
Aetna	$307 - $2,274	126%
Blue Cross Blue Shield	$307 - $1,095	126%
Health Net Senior	$307	126%
La Care Covered California	$307	126%
Medicare (plans)	$307 - $322	126%
Ambetter / Centene	$433	178%
Heritage Provider Network (Regal & Lakeside)	$476	195%
Health Net	$607 - $760	249%
UnitedHealthcare	$866 - $3,095	355%
Cigna	$957	393%
Blue Shield Promise Medi-Cal	$994	408%
Blue Shield Ifp	$1,768	725%
Blue Shield	$2,100	861%
La Care Medi-Cal	$2,387	979%
Phcs	$2,387	979%
Coventry Health Care (Ccn)	$2,785	1142%
Beech Street	$2,984	1224%
Multiplan	$3,580	1469%

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 $3,978.
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 Valley Presbyterian 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.