CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $837
  • Cash Discount Price: $1,482
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Nemours Children's Hospital, Delaware is $837. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,482. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.43x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$1,482

Average discount available for prompt cash payment at this facility.

Insurance Median
$837

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: $1,482 (608%)
Insurance Median: $837 (343%)
Cash: $1,482 (608% of Medicare)
Ins. Median: $837 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
Us Family Health Plan $76 31%
Tricare $253 104%
Keystone First Hlth Plan $296 - $656 121%
Celtic Transplant $330 - $1,482 135%
Amerihealth Caritas Delaware $454 - $845 186%
Blue Cross Blue Shield $459 - $1,309 188%
Celtic Transplant For De First Health $519 213%
Delaware First Health $534 219%
UnitedHealthcare $544 - $925 223%
Wellpoint Maryland $548 225%
Kidz Partners $560 230%
Health Partners $575 236%
Upmc $587 241%
Fidelis $593 243%
Aetna $629 - $860 258%
Priority Partners John Hopkins $727 298%
Six Degrees Health Transplant $741 304%
Cigna $815 - $934 334%
Great West-One Health Plan $815 - $934 334%
Ambetter / Centene $845 347%
Geisinger Health Plan $889 365%
Integra Administrative Group $889 365%
National Transplant Network (Ntn) $963 395%
Six Degrees Health $963 395%
Star Healthcare Network $963 395%
Life Trac Solid Organ And Bmt Transplant $1,037 425%
First Health Network $1,408 578%
Insurance Administrators Of America $1,408 578%
Interlink Transplant Network $1,408 578%
Multiplan $1,408 578%
Preferred Healthcare $1,408 578%
Private Healthcare Systems $1,408 578%
Three Rivers Provider Network $1,408 578%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens