CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Fishermen's Community Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,519
Cash Discount Price: $3,775
vs. Medicare Baseline: 6.23x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Fishermen's Community Hospital is $1,519. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,775. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.23x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$3,775

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,519

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: $3,775 (1549%)

Insurance Median: $1,519 (623%)

Cash: $3,775 (1549% of Medicare)

Ins. Median: $1,519 (623% 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 623% of the Medicare baseline (a markup of 523%). 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
Amerigroup	$74 - $147	30%
Medicaid / KanCare	$74 - $162	30%
UnitedHealthcare	$74 - $5,808	30%
Wellcare	$77 - $155	32%
Sunshine State	$78 - $156	32%
Aetna	$80 - $4,449	33%
Vista	$80 - $159	33%
Blue Cross Blue Shield	$970 - $5,808	398%
Leon Medical	$1,220	500%
Medica Health Plan	$1,220	500%
Medicare (plans)	$1,220 - $1,647	500%
Humana	$1,329	545%
Avmed	$1,342 - $4,809	551%
Cigna	$1,390 - $4,646	570%
Non Contracted	$2,132	875%
International	$3,775	1549%
Amerihealth	$4,356	1787%
Dimension Health Plan	$4,356 - $5,227	1787%
Affordable	$5,227	2144%
Phcs	$5,227	2144%
Quality Health	$5,227	2144%

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 $3,775.
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 Fishermen's Community 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.