CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Halifax Health Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $490
  • Cash Discount Price: $4,316
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Halifax Health Medical Center is $490. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,316. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.01x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
$4,316

Average discount available for prompt cash payment at this facility.

Insurance Median
$490

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: $4,316 (1771%)
Insurance Median: $490 (201%)
Cash: $4,316 (1771% of Medicare)
Ins. Median: $490 (201% 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 201% of the Medicare baseline (a markup of 101%). 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
Coventry $154 - $3,410 63%
Hcra $154 63%
Humana $154 - $483 63%
Medicaid / KanCare $154 63%
Molina $154 - $247 63%
UnitedHealthcare $154 - $3,237 63%
West Volusia $154 63%
Aetna $162 - $3,237 66%
Independent Living Systems $162 - $255 66%
Simply Healthcare Plans $162 66%
Sunshine State Health Plan $162 - $485 66%
Caresource Network $169 69%
Embs $206 - $4,586 85%
Tricare $226 93%
Americas Choice Provider Network $243 - $4,856 100%
Blue Cross Blue Shield $243 - $2,374 100%
Cigna $243 100%
Division Of The Blind $243 100%
Freedom Health $243 100%
Medicare (plans) $243 100%
Optimum Healthcare $243 100%
Wellcare $243 100%
Devoted Health $252 103%
Longevity $255 105%
Prime Health Services $255 - $3,237 105%
Clear Spring Health Of Fl $264 108%
Employers Health Network $485 199%
Fhcp $490 201%
Centivo $522 214%
Florida Healthcare $527 216%
Claimdoc $546 224%
Florida Healthcare - Hecn $1,845 757%
Avmed $2,482 - $2,698 1018%
County Of Volusia Corrections $2,698 1107%
A&G Admin $2,751 1129%
Volusia County Employee $2,751 1129%
Oscar $3,237 1328%
Volusia $3,237 - $3,776 1328%
Sim Plan Pay $3,507 1439%
Hrgi $3,776 1549%
Plotkin Consulting $3,776 1549%
Evolutions International $4,046 1660%
Summit America $4,316 1771%
Integrated Health Plan $4,856 1992%
Multiplan $4,856 1992%
Three Rivers $5,125 2102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals