CMS Price Transparency Data
MRI, lower back (no contrast)
Facility: John Muir Medical Center - Walnut Creek Campus
Billing Code: 72148 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72148
- Insurance Median: $337
- Cash Discount Price: $2,320
- vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at John Muir Medical Center - Walnut Creek Campus is $337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,320. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.38x the Medicare baseline. Located in 1601 Ygnacio Valley Rd, Walnut Creek, CA.
Cash / Self-Pay
$2,320
Average discount available for prompt cash payment at this facility.
Insurance Median
$337
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: $2,320 (952%)
Insurance Median: $337 (138%)
Cash: $2,320 (952% of Medicare)
Ins. Median: $337 (138% 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
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 |
|---|---|---|
| Jmpn Canopy Hn [1640000011] | $124 | 51% |
| UnitedHealthcare | $124 - $1,212 | 51% |
| Aetna | $179 - $337 | 73% |
| Contra Costa County Jail [1012104] | $186 | 76% |
| United Behavioral Health [1048103] | $280 | 115% |
| Golden State-Network Mcare [1023127] | $303 | 124% |
| Health Net-Network Mcare [1028127] | $330 | 135% |
| Alignment Health [1177113] | $337 | 138% |
| Blue Cross Blue Shield | $337 - $3,351 | 138% |
| Blue Shield-Network Mcare [1006127] | $337 | 138% |
| Care 1St Health Plan [1094113] | $337 | 138% |
| Caremore [1171113] | $337 | 138% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $337 | 138% |
| Easy Choice Health Plan [1083113] | $337 | 138% |
| Essence Healthcare [1049028] | $337 | 138% |
| Essence Healthcare [1049128] | $337 | 138% |
| Hospice Of East Bay [1085104] | $337 | 138% |
| Humana | $337 - $4,279 | 138% |
| Medicare (plans) | $337 - $4,124 | 138% |
| Scan-Network Mcare [1043127] | $337 | 138% |
| Veterans Administration [1051113] | $337 | 138% |
| Tricare | $346 | 142% |
| Workers' Comp [1024005] | $354 | 145% |
| Generic Commercial/Indemnity [1017001] | $421 - $2,062 | 173% |
| Generic Hmo [1018103] | $421 | 173% |
| Generic Ppo [1021104] | $421 | 173% |
| Canopy Hn Hmo [1166103] | $617 | 253% |
| Blue Shield Hmo [1006103] | $1,212 - $1,237 | 497% |
| Blue Shield-Network [1006026] | $1,212 - $1,237 | 497% |
| Blue Shield Ppo [1006104] | $1,237 - $1,299 | 507% |
| Health Net Hmo [1028103] | $1,257 | 516% |
| Health Net Ppo [1028104] | $1,257 | 516% |
| Health Net-Network [1028026] | $1,257 | 516% |
| Cigna | $1,334 | 547% |
| Carecentrix [1011001] | $2,062 | 846% |
| Aps Healthcare [1003103] | $2,320 | 952% |
| Carelon Behavioral Health [1050104] | $2,836 | 1163% |
| Fortified Provider Network [1063104] | $2,836 | 1163% |
| Medigap [1036001] | $2,836 | 1163% |
| Three Rivers Provider Network [1073104] | $2,836 | 1163% |
| Contra Costa Health Plan Hmo [1013103] | $3,093 | 1269% |
| Western Health Advantage Hmo [1053103] | $3,609 - $4,124 | 1480% |
| Donor Network West [1008103] | $4,000 | 1641% |
| Federal Correction Institute [1062104] | $4,124 | 1692% |
| First Health [1016104] | $4,124 - $4,382 | 1692% |
| Healthsmart - Pka Interplan [1031104] | $4,124 | 1692% |
| Networks By Design [1084104] | $4,124 | 1692% |
| Pponext [1072104] | $4,124 | 1692% |
| Sutter Preferred Health Plan [1044104] | $4,124 | 1692% |
| Kaiser Hmo [1033103] | $4,176 | 1713% |
| Health Management Network [1066104] | $4,382 | 1798% |
| Healthcomp [1089104] | $4,382 | 1798% |
| Galaxy Health Network [1064104] | $4,640 | 1903% |
| Integrated Health Plan [1075104] | $4,640 | 1903% |
| National Provider Network/Plancare America [1069104] | $5,156 | 2115% |