CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health Sierra Vista

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,361
Cash Discount Price: $822
vs. Medicare Baseline: 13.79x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health Sierra Vista is $3,361. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $822. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.79x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$822

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,361

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: $822 (337%)

Insurance Median: $3,361 (1379%)

Cash: $822 (337% of Medicare)

Ins. Median: $3,361 (1379% 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 1379% of the Medicare baseline (a markup of 1279%). 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
Aetna	$306	126%
Cencal Mcr Adv - All Other Plans	$306	126%
Tricare	$306	126%
UnitedHealthcare	$306 - $3,142	126%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$398	163%
Ah Employee Health Plan - All Plans	$551	226%
Hpn-Heritage Prov Ntwrk-All Plans	$3,105	1274%
Blue Shield Epn	$3,580	1469%
Blue Shield Hmo/Pos	$4,457	1828%
Blue Shield Epo/Ppo-All Other Plans	$4,914	2016%
Nbd-Ntwrks By Design Exclus-All Other Plans	$5,274	2164%
Nbd-Ntwrks By Design Non-Exclus	$5,274	2164%
Medi-Cal	$9,133	3747%
Cencal Mcal	$10,412	4271%
Blue Shield Promise Mcal	$10,978	4503%
Ccah-Centrl Ca Allince Mcal-All Plans	$11,873	4871%
Coalinga-All Plans	$11,873	4871%

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 $822.
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 Sierra Vista 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.