CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $267
Cash Discount Price: $6,384
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Shriners Hospitals for Children Northern Calif is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,384. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.10x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$6,384

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $6,384 (2619%)

Insurance Median: $267 (110%)

Cash: $6,384 (2619% of Medicare)

Ins. Median: $267 (110% 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.

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
Kaiser Permanente	$100 - $267	41%
Soonercare	$162	66%
Ambetter / Centene	$227 - $356	93%
Amerigroup Nv	$231	95%
UnitedHealthcare	$233	96%
Aetna	$234 - $310	96%
Medicaid / KanCare	$234	96%
Molina Healthcare Of Ms	$234	96%
Gateway Health Plan	$256	105%
Health Plan Of Nv	$257	105%
Blue Cross Blue Shield	$267 - $522	110%
Central California Alliance For Health	$267	110%
Health Plan Of San Joaquin	$267	110%
Molina Healthcare Of Ca	$267	110%
Partnership Healthplan Of Ca	$267	110%
Amerihealth Caritas Nc	$269	110%
Amerihealth Caritas Sc	$269	110%
Caresource Of Oh	$269	110%
Cigna	$282	116%
Providence Health Plan	$296	121%
Northbay Healthcare	$310	127%
Sana Benefits	$327 - $434	134%
Sutter Medical Foundation	$341	140%
Health Net Of Ca	$356	146%
Healthchoice Of Oklahoma	$604	248%

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 $6,384.
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 Shriners Hospitals for Children Northern Calif 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.