CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: AHMC Seton Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $461
  • Cash Discount Price: $4,642
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at AHMC Seton Medical Center is $461. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,642. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.89x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$4,642

Average discount available for prompt cash payment at this facility.

Insurance Median
$461

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: $4,642 (1904%)
Insurance Median: $461 (189%)
Cash: $4,642 (1904% of Medicare)
Ins. Median: $461 (189% 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.

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 Cross Blue Shield $58 - $4,407 24%
Hill Physicians Medical Group Inc $161 - $826 66%
Medi-Cal $186 76%
San Mateo County/San Mateo County General Hospital $229 94%
Veterans Administration (Va) $243 100%
Jade Health Care Mg $259 - $341 106%
North East Medical Services $260 - $341 107%
San Francisco Health Plan $260 107%
Aetna $341 - $965 140%
Asian American Medical Group $341 - $991 140%
Blue Shield Of California $341 - $6,783 140%
Brand New Day $341 - $433 140%
Brown And Toland Medical Group $341 - $1,032 140%
Care Advantage $341 140%
Chinese Community Health Plan $341 - $2,901 140%
For Your Benefit $341 140%
Healthnet Seniority $341 140%
Humana $341 140%
Imperial Health Plan $341 140%
Medicare (plans) $341 140%
Pacificare $341 140%
Tricare $345 142%
Apcmg $346 - $520 142%
Canopy Health $346 - $624 142%
Covid-19 Uninsured Program $346 142%
Kaiser $346 - $4,758 142%
UnitedHealthcare $346 - $376 142%
Easy Choice Hospital Services $353 145%
Central Health Plan $368 151%
Ahmc Health $433 178%
Knox-Keene Act $433 178%
Athens Administrators $461 189%
Corvel Healthcare $461 189%
Multiplan/Bce Emergis $461 - $4,352 189%
Work Comp Other $461 189%
Health Plan Of San Mateo Healthworx $691 283%
Health Plan Of San Mateo $786 322%
Cmac $826 339%
Self Pay $870 - $1,973 357%
Workers Compensation Federal $980 402%
Interplan Corporation $3,481 1428%
Cigna $4,061 1666%
Health Net $4,298 1763%
Private Healthcare Sytems Inc $4,352 1785%
The First Health Network $4,352 1785%
Beech Street Corporation $4,642 1904%
Healthcare Foundation Of San Mateo $4,642 1904%
Choicecare Network $4,932 2023%
Multiplan $4,932 2023%
Mills Peninsula Health Services $5,222 2142%
Indemnity $5,802 2380%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals