CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Valley Children's Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $3,534
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 14.50x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Valley Children's Hospital is $3,534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.50x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,534

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%)
Insurance Median: $3,534 (1450%)
Ins. Median: $3,534 (1450% 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 1450% of the Medicare baseline (a markup of 1350%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Allcare Ipa $826 339%
Kaiser $835 - $4,376 343%
Blue Cross Blue Shield $1,038 - $5,405 426%
Dignity Ipa_Formerly Img $1,156 474%
La Salle Ipa $1,156 474%
Sante Ipa $1,156 474%
Central Valley Medical Providers Ipa $1,239 - $3,366 508%
Sequoia Health Ipa $1,239 508%
Univseral Healthcare Ipa $1,239 508%
United Physicians Network Ipa $1,280 525%
Community Care Ipa $1,305 535%
Adventist $1,457 598%
UnitedHealthcare $1,549 635%
Cencal Health $1,633 670%
Kern Family Health Care $1,650 677%
Central California Alliance For Health $1,680 689%
Health Net $2,369 - $4,408 972%
Dignity Health Central Coast $3,336 1369%
Community Health $3,703 1519%
Stanislaus Partners In Health $3,703 1519%
Physicians Choice Medical Group $3,770 1547%
Health Plan Of San Joaquin $4,039 1657%
Fowler Packing $4,174 1712%
Dignity (Formerly Managed Care Systems) $4,241 1740%
Kern Legacy $4,376 1795%
Blue Shield $4,496 - $5,108 1844%
Aetna $4,510 1850%
First Health Formerly Coventry $4,982 2044%
Bakersfield Family Medical Group $5,049 2071%
Network By Design $5,217 2140%
Community Care Health Plan $5,384 2209%
Health Smart $5,386 2209%
Key Medical Ipa $5,386 2209%
Sutter Health $5,722 2347%
Multiplan $6,440 2642%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens