CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,714
Cash Discount Price: $6,223
vs. Medicare Baseline: 11.13x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Central Florida Lake Monroe Hospital is $2,714. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,223. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.13x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$6,223

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,714

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: $6,223 (2553%)

Insurance Median: $2,714 (1113%)

Cash: $6,223 (2553% of Medicare)

Ins. Median: $2,714 (1113% 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 1113% of the Medicare baseline (a markup of 1013%). 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
Freedom Health	$448	184%
Optimum	$448	184%
United	$518 - $2,800	212%
Simply	$958	393%
Molina Healthcare	$1,182 - $1,991	485%
Aetna	$1,580 - $1,947	648%
Sunshine State Health Plan	$1,587	651%
Corvel Corporation	$2,496	1024%
Prime Health	$2,548	1045%
Careworks (Rockport Community)	$2,627	1078%
Avmed	$3,110 - $3,418	1276%
Plotkin Health	$3,112	1277%
Prime Health Sheriff	$3,112	1277%
Multiplan	$4,667 - $5,290	1915%
Three Rivers Provider Network	$4,667	1915%
Ppo Next	$5,290	2170%
Novanet	$5,601	2298%

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 $6,223.
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 Central Florida Lake Monroe Hospital 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.