CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Lower Keys Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $499
  • Cash Discount Price: $2,258
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Lower Keys Medical Center is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,258. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.05x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$2,258

Average discount available for prompt cash payment at this facility.

Insurance Median
$499

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: $2,258 (926%)
Insurance Median: $499 (205%)
Cash: $2,258 (926% of Medicare)
Ins. Median: $499 (205% 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 205% of the Medicare baseline (a markup of 105%). 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
UnitedHealthcare $62 - $5,601 25%
Veterans Eval Services $228 94%
Florida Childrens Medical Services $234 96%
Medicaid / KanCare $234 - $257 96%
South Florida Community Care Network $234 96%
Humana $241 - $263 99%
Tricare $254 104%
Amerigroup $257 105%
Positive Healthcare $257 105%
Simply Healthcare $257 - $2,258 105%
Wellcare $257 105%
Wellcare Healthease $257 105%
Blue Cross Blue Shield $263 - $6,349 108%
Medicare (plans) $263 108%
Ultimate Health $263 108%
Molina $264 108%
Node Champva $267 110%
Node Non Par Hospice Agree $267 110%
Node United Behavioral Va Ccn $267 110%
Node Va $267 110%
Prestige Health Choice $271 111%
Magellan $280 115%
Correct Care Solutions $294 121%
Node Us Dept Of Labor $334 137%
Prime Health Work Comp Fl $451 185%
Fl Work Comp $465 191%
Heritage Summit Work Comp Fl $465 191%
State Auto Insurance Fl $534 219%
Self Pay $1,967 - $2,549 807%
Cigna $4,297 1763%
Aetna $5,084 2086%
Monroe County $5,463 2241%
Evolutions Healthcare Systems $5,827 - $6,920 2390%
Keys Energy $5,827 2390%
Prime Health Ppo $5,827 2390%
Avmed Health Plan $6,191 2540%
Direct Healthcare $7,284 2988%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals