CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,579
Cash Discount Price: $5,260
vs. Medicare Baseline: 10.58x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Nemours Childrens Hospital, Florida is $2,579. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,260. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.58x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$5,260

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,579

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: $5,260 (2158%)

Insurance Median: $2,579 (1058%)

Cash: $5,260 (2158% of Medicare)

Ins. Median: $2,579 (1058% 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 1058% of the Medicare baseline (a markup of 958%). 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
Tricare	$243	100%
Avmed	$900	369%
Aetna	$1,391	571%
Truli	$1,533 - $2,104	629%
Florida Blue	$1,703 - $3,232	699%
Evolutions Healthcare	$1,802	739%
Employers Health Network Fl	$2,104	863%
Cigna	$2,475	1015%
UnitedHealthcare	$2,912	1195%
Integra Administrative Group	$3,156	1295%
Global Medical Management	$3,419	1403%
Prime Health Services	$3,419	1403%
Star Healthcare Network	$3,419	1403%
Velocity	$3,945	1618%
First Health Network	$4,103	1683%
Pnoa	$4,208	1726%
Seminole Tribe Of Fl	$4,208	1726%
Private Healthcare Systems	$4,839	1985%

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 $5,260.
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 Nemours Childrens Hospital, Florida 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.