CMS Price Transparency Data
MRI, lower back (no contrast)
Facility: San Gabriel Valley Medical Center
Billing Code: 72148 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72148
- Insurance Median: $408
- Cash Discount Price: $2,393
- vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at San Gabriel Valley Medical Center is $408. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,393. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.67x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$2,393
Average discount available for prompt cash payment at this facility.
Insurance Median
$408
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: $2,393 (982%)
Insurance Median: $408 (167%)
Cash: $2,393 (982% of Medicare)
Ins. Median: $408 (167% 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.
Out-of-Pocket Cost Estimator
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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 | $58 - $1,684 | 24% |
| Altamed Health Network | $186 - $302 | 76% |
| Beverly Hospital | $186 - $338 | 76% |
| Brand New Day | $186 - $384 | 76% |
| Emanate Health | $186 - $384 | 76% |
| Healthnet Medi-Cal Non-Contract | $186 | 76% |
| Non Contracting Medi Cal | $186 | 76% |
| La Care Health Plan | $214 - $307 | 88% |
| Veterans Administration | $215 | 88% |
| Aetna | $302 - $486 | 124% |
| Alignment Health Plan | $302 | 124% |
| Apa/Aco Inc | $302 | 124% |
| Avanti | $302 - $826 | 124% |
| Blue Shield Of California | $302 - $5,316 | 124% |
| Central Health Plan | $302 - $1,000 | 124% |
| Health Net | $302 - $3,844 | 124% |
| Health Net Inc | $302 - $717 | 124% |
| Humana | $302 | 124% |
| Medicare (plans) | $302 - $317 | 124% |
| Molina Healthcare Of California | $302 - $478 | 124% |
| Pacific Alliance Medical Center | $302 | 124% |
| Pacificare Of California | $302 - $1,477 | 124% |
| Providence Health Network | $302 | 124% |
| Tricare | $302 | 124% |
| Wellcare | $302 | 124% |
| Aids Healthcare Foundation | $307 - $1,800 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx | $307 | 126% |
| Inter Valley Health Plan | $307 | 126% |
| Physicians Healthways | $307 - $826 | 126% |
| Self-Pay | $307 | 126% |
| St Vincent Medical Center/Psych | $307 | 126% |
| Chinatown Service Center Pace | $362 | 149% |
| Care 1St Health Plan | $375 - $600 | 154% |
| UnitedHealthcare | $376 | 154% |
| Ahmc Health Self-Insurance Epo | $384 | 158% |
| Knox-Keene Act | $384 | 158% |
| Athens Administrators | $408 | 167% |
| Beech Street | $408 - $6,381 | 167% |
| Other Non Contracting Workers Comp | $408 | 167% |
| Ahmc Medi-Cal Reciprocity | $451 | 185% |
| Ahmc Reciprocity | $451 | 185% |
| Affiliated Health Fund | $700 | 287% |
| Healthy Way La | $826 | 339% |
| Hollywood Presbyterian Adv Med Mcal | $826 | 339% |
| Hollywood Presbyterian Medpoint Mcal | $826 | 339% |
| Medicaid / KanCare | $826 | 339% |
| Pacific Independent Physician Associates | $850 | 349% |
| Private Pay | $1,027 | 421% |
| Cigna | $2,059 | 845% |
| Facey Medical | $3,988 | 1636% |
| Community Care Network | $4,928 | 2022% |
| Choicecare Network | $5,583 | 2290% |
| Private Healthcare Systems (Phcs) | $5,583 | 2290% |
| Multiplan | $7,178 | 2945% |
| Ppo Next | $7,178 | 2945% |
| Managed Health Network | $7,976 | 3272% |
| Medi-Cal Sub Acute | $7,976 | 3272% |
| One Legacy | $7,976 | 3272% |
| Other Non Contracted Commercial | $7,976 | 3272% |
| Us Behavioral Health Plan | $7,976 | 3272% |