CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Modoc Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,193
Cash Discount Price: $2,668
vs. Medicare Baseline: 9.00x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Modoc Medical Center is $2,193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,668. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.00x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$2,668

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,193

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: $2,668 (1094%)

Insurance Median: $2,193 (900%)

Cash: $2,668 (1094% of Medicare)

Ins. Median: $2,193 (900% 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 900% of the Medicare baseline (a markup of 800%). 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
Multiplan Wc	$232	95%
Ntwrks By Design Wc - All Plans	$241	99%
Integrated Hp Wc	$244	100%
Adv Med Mgmt - All Plans	$390	160%
Medi-Cal	$390	160%
Medi-Cal 7/1/24	$390	160%
Partnership Hp - All Plans	$1,365	560%
Blue Shield Mcr Adv	$1,444	592%
Blue Shield Va	$1,444	592%
UnitedHealthcare	$1,444 - $2,534	592%
Tricare	$1,520	624%
Healthnet Mcr Adv	$1,536	630%
Blue Shield Comm - All Other Plans	$1,800	738%
Blue Cross Blue Shield	$2,193 - $2,437	900%
Blue Shield Exch	$2,193	900%
Carelon - All Plans	$2,437	1000%
Corvel - All Plans	$2,507	1028%
Aetna	$2,534	1040%
Coventry/First Health - All Plans	$2,534	1040%
Galaxy Health - All Plans	$2,534	1040%
Healthnet Comm - All Other Plans	$2,534	1040%
Hmn - All Plans	$2,534	1040%
Integrated Hp - All Other Plans	$2,534	1040%
Interplan - All Plans	$2,534	1040%
Multiplan - All Other Plans	$2,534	1040%
Superior Ca Ppo - All Plans	$2,534	1040%

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 $2,668.
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 Modoc Medical Center 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.