CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Spanish Peaks Regional Health Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $972
  • Cash Discount Price: $972
  • vs. Medicare Baseline: 3.99x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Spanish Peaks Regional Health Center is $972. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $972. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.99x the Medicare baseline. Located in 23500 Us Highway 160, Walsenburg, CO.
Cash / Self-Pay
$972

Average discount available for prompt cash payment at this facility.

Insurance Median
$972

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: $972 (399%)
Insurance Median: $972 (399%)
Cash: $972 (399% of Medicare)
Ins. Median: $972 (399% 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 399% of the Medicare baseline (a markup of 299%). 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
Beacon Health Op Only-All Plans $368 151%
Blue Cross Blue Shield $529 - $972 217%
Humana $529 217%
Medicare (plans) $529 217%
UnitedHealthcare $529 - $1,004 217%
Devoted Health Mcr - All Plans $556 228%
Apostrophe - All Plans $972 399%
Cigna $972 399%
Friday Hp Chp - All Plans $972 399%
Kaiser Ppo - All Other Plans $972 399%
Prov Ntwrk Of America - All Plans $972 399%
Cofinity - All Plans $994 408%
Connect For Health - All Plans $1,004 412%
Rmhp - All Plans $1,004 412%
Multiplan Phcs - All Plans $1,026 421%
Kaiser Ppo Mcr $1,080 443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 23500 Us Highway 160, Walsenburg, CO 81089
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals