CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health Vallejo

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,591
Cash Discount Price: $1,061
vs. Medicare Baseline: 14.73x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health Vallejo is $3,591. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,061. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.73x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$1,061

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,591

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: $1,061 (435%)

Insurance Median: $3,591 (1473%)

Cash: $1,061 (435% of Medicare)

Ins. Median: $3,591 (1473% 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 1473% of the Medicare baseline (a markup of 1373%). 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
Cigna	$39 - $6,703	16%
Blue Shield Mcr Adv	$69 - $242	28%
Medicare (plans)	$69 - $242	28%
Napa County Mcal Child	$69 - $242	28%
Tricare	$69 - $242	28%
Ah Employee Health Plan-All Plans	$76 - $435	31%
Interplan-All Plans	$83 - $5,027	34%
Kaiser-All Plans	$83 - $7,038	34%
Blue Shield Epn	$89 - $3,947	37%
Blue Shield Non-Epn-All Other Plans	$89 - $3,888	37%
UnitedHealthcare	$93 - $5,342	38%
Western Growers-All Plans	$102 - $4,441	42%
Phcs-All Plans	$168 - $4,608	69%
Medi-Cal	$186 - $390	76%
Aetna	$204 - $2,030	84%
Va Mcr-All Other Plans	$242	99%
Health Management Network-All Plans	$260 - $7,122	107%
Three Rivers-All Plans	$275 - $7,541	113%
Va Medi-Cal	$390	160%
Healthnet-All Plans	$1,725	708%
Blue Cross Blue Shield	$1,933 - $2,319	793%
Blue Shield Behav Hlth	$2,693 - $3,771	1105%
Choicecare-All Plans	$4,190 - $5,865	1719%
Beech Street-All Plans	$4,489 - $6,284	1841%
Galaxy Network-All Plans	$5,386 - $7,541	2209%

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 $1,061.
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 Adventist Health Vallejo 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.