CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Casa Colina Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $387
  • Cash Discount Price: $399
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Casa Colina Hospital is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.59x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$399

Average discount available for prompt cash payment at this facility.

Insurance Median
$387

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: $399 (164%)
Insurance Median: $387 (159%)
Cash: $399 (164% of Medicare)
Ins. Median: $387 (159% 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
Heritage Prvdr Ntwrk Mcal $246 101%
Prospect Hp Mcal $276 113%
Promed Hlth Ntwrk Op Only - All Plans $292 120%
Aetna $307 - $701 126%
Blue Cross Blue Shield $307 - $822 126%
Blue Shield Mcr Adv $307 126%
Caremore Mcr Adv - All Plans $307 126%
Central Hlth Plan - All Plans $307 126%
Doctors Managed Op Only - All Plans $307 126%
Empire Healthcare Op Only - All Plans $307 126%
Focus Healthcare Wc - All Plans $307 126%
Healthnet Mcr Adv $307 126%
Humana $307 - $701 126%
Iehp - All Other Plans $307 126%
Iehp Mcr Adv $307 126%
Kaiser Comm - All Other Plans $307 126%
Kaiser Mcr Adv $307 126%
Premiercare Op Only - All Plans $307 126%
Prospect Hp Mcr Adv $307 126%
Triwest - All Plans $307 126%
UnitedHealthcare $307 - $701 126%
Wellcare Mcr Adv - All Plans $307 126%
Prospect Hp Comm - All Other Plans $338 139%
Affiliated Hlth Funds - All Plans $384 158%
Medi-Cal $390 160%
Kaiser Mcal $429 176%
Epic Comm - All Other Plans $525 215%
Epic Mcr Adv $525 215%
Healthcare Partners - All Other Plans $525 215%
Healthcare Partners Mcr $525 215%
Primecare Comm - All Other Plans $525 215%
Primecare Mcr Adv $525 215%
Heritage Prvdr Ntwrk Comm - All Other Plans $561 230%
Heritage Prvdr Ntwrk Mcr $561 230%
Healthnet Comm - All Other Plans $575 236%
Corvel - All Plans $701 288%
Coventry - All Plans $701 288%
Multiplan - All Plans $701 288%
Three Rivers - All Plans $701 288%
Cigna $784 322%
Brand New Day Mcr Adv - All Plans $842 345%
Iehp Mcal $975 400%
Galaxy Provdr Ntwrk - All Plans $982 403%
Blue Shield Comm - All Other Plans $1,037 425%
Prospect Med Grp Alta - All Plans $1,192 489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals