CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: City of Hope National Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,677
Cash Discount Price: $2,396
vs. Medicare Baseline: 6.88x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at City of Hope National Medical Center is $1,677. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,396. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.88x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$2,396

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,677

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: $2,396 (983%)

Insurance Median: $1,677 (688%)

Cash: $2,396 (983% of Medicare)

Ins. Median: $1,677 (688% 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 688% of the Medicare baseline (a markup of 588%). 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
Health Net	$126 - $2,324	52%
Cal Optima	$144 - $260	59%
Heritage Provider Network	$180 - $1,677	74%
Inland Empire	$180 - $1,916	74%
Prime Healthcare Keenan	$252 - $2,300	103%
Healthcare Partners	$635	260%
Aetna	$1,093	448%
UnitedHealthcare	$1,146 - $1,341	470%
Blue Cross Blue Shield	$1,198 - $3,511	491%
Blue Shield	$1,418 - $2,855	582%
Blue Shield Covca	$1,456	597%
Blue Shield Promise	$1,677	688%
Cencal	$1,916	786%
La Care Health	$1,916	786%
Kaiser	$2,156	884%
Gold Coast	$2,396	983%
Molina	$2,396 - $3,114	983%
Cigna	$2,573	1056%
Facey	$2,635	1081%
St. Joseph Heritage	$2,875	1179%
Primecare Medical Network	$3,114	1277%
First Health	$3,689	1513%
Phcs Multiplan	$4,312	1769%

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 $2,396.
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 City of Hope National Medical Center 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.