CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Loma Linda University Children's Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,226
Cash Discount Price: $2,496
vs. Medicare Baseline: 5.03x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Loma Linda University Children's Hospital is $1,226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,496. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.03x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$2,496

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,226

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: $2,496 (1024%)

Insurance Median: $1,226 (503%)

Cash: $2,496 (1024% of Medicare)

Ins. Median: $1,226 (503% 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 503% of the Medicare baseline (a markup of 403%). 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
Alpha Care Medical Group	$307 - $461	126%
Dignity Health	$307 - $461	126%
Epic Health Plan	$307 - $2,452	126%
Inland Empire Health Plan (Iehp)	$307 - $312	126%
Kaiser Foundation Hospitals	$307 - $4,088	126%
Upland Medical Group	$307	126%
Vantage Medical Group	$307 - $461	126%
Molina Healthcare Of Ca	$387 - $412	159%
Heritage Provider Network	$504	207%
UnitedHealthcare	$866	355%
Adventist Health	$993 - $1,226	407%
Lluh Dept Of Risk Management	$1,192 - $1,471	489%
Blue Shield Of California	$2,006 - $3,039	823%
Global Benefits Group	$2,979 - $3,677	1222%
Temecula Valley Physicians Medical Group	$2,979	1222%
Trivalley Medical Group	$2,979	1222%
Blue Cross Blue Shield	$3,049	1251%
Cigna	$3,178 - $3,674	1304%
Networks By Design	$3,227 - $3,984	1324%
Aetna	$3,443	1412%
Multiplan	$3,972 - $4,903	1629%
Galaxy Health	$4,220 - $5,210	1731%
Prime Health Services	$4,220 - $5,210	1731%

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 $2,496.
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 Loma Linda University Children's Hospital 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.