CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health and Rideout

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,491
Cash Discount Price: $1,194
vs. Medicare Baseline: 14.32x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health and Rideout is $3,491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,194. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.32x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$1,194

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,491

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: $1,194 (490%)

Insurance Median: $3,491 (1432%)

Cash: $1,194 (490% of Medicare)

Ins. Median: $3,491 (1432% 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 1432% of the Medicare baseline (a markup of 1332%). 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
Bc Mcal	$268	110%
Kaiser Mcr Adv	$308	126%
Tricare	$308	126%
UnitedHealthcare	$308 - $4,716	126%
Blue Cross Blue Shield	$311 - $1,657	128%
Kaiser Mcal	$390	160%
Medi-Cal	$390	160%
Ca Health And Wellness- All Plans	$484	199%
Celtic Mcaid-All Plans	$484	199%
Ah Employee Health Plan - All Plans	$554	227%
Healthnet Mcal	$1,086	446%
Healthnet Comm-All Other Plans	$3,491	1432%
Aetna	$3,838	1574%
Kaiser-All Other Plans	$4,126	1693%
Blue Shield Uc Care Members	$4,343	1782%
Cigna	$4,627	1898%
First Health-All Plans	$4,750	1949%
Phcs-All Plans	$4,778	1960%
Interplan-All Plans	$4,886	2004%
Blue Shield-All Other Plans	$5,158	2116%
Multiplan-All Plans	$5,158	2116%
Partnership Hp Mcal -All Plans	$8,958	3675%

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 $1,194.
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 Adventist Health and Rideout 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.