CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health Tulare

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $307
  • Cash Discount Price: $619
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health Tulare is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $619. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.26x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$619

Average discount available for prompt cash payment at this facility.

Insurance Median
$307

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: $619 (254%)
Insurance Median: $307 (126%)
Cash: $619 (254% of Medicare)
Ins. Median: $307 (126% 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
Cigna $39 - $2,887 16%
Blue Shield Mcare $70 - $307 29%
Fhcn Pace Mcr Adv - All Plans $70 - $307 29%
Medicare (plans) $70 - $307 29%
Tricare $70 - $307 29%
UnitedHealthcare $70 - $4,517 29%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $70 29%
Ah Employee Health Plan - All Plans $77 - $552 32%
Incentive Hlth - All Plans $77 - $552 32%
Hs Interplan-All Plans $87 - $4,178 36%
Cal Forensic Med Grp - All Plans $91 - $399 37%
Healthnet Hmo/Ppo - All Other Plans $102 - $818 42%
Blue Cross Blue Shield $113 - $1,847 46%
Blue Shield Epn $128 - $1,971 53%
Blue Shield-All Other Plans $135 - $2,725 55%
Ccipa Medi-Cal - All Plans $186 - $507 76%
Healthnet Medi-Cal $186 - $511 76%
Medi-Cal $186 - $390 76%
Upn-United Physcn Ntwrk Mcal Profee Only $186 76%
Dignity Mcr Op Only - All Other Plans $307 126%
Prime Health - All Plans $307 126%
Aetna $335 - $2,084 137%
Prison Hlthcre - All Plans $393 161%
Dignity Mcal Op Only $429 176%
Independence Op Only - All Plans $429 176%
Bright Health - All Plans $445 183%
Western Growers - All Plans $2,869 1177%
Network By Design-All Plans $3,000 1231%
Multiplan - All Plans $5,301 2175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals