CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: St Marys Good Samaritan Hospital

Billing Code: 72148 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$581

about 2.4× the $244 Medicare rate · typically $208–$1,182

modeled estimate · not a bill or quote

Medicare pays $244 Fair price $581 Cash price $1,608 Hospital's list price $2,474

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$668 - $2,632	274%
Blue Cross Blue Shieldmajor	$478 - $1,787	196%
Aetnamajor	$668 - $1,979	274%
Cignamajor	$668 - $2,029	274%
Humanamajor	$668 - $1,856	274%
Kaiser Permanentemajor	$668	274%
Ambetter (Centene)	$668	274%
Amerigroup	$365	150%
CareSource	$668	274%
Molina	$668	274%
WellCare	$504 - $668	207%
+ 5 smaller / regional plans	$668 - $2,227

Government programs also on file: Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,608), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72148.

Insurance Before you use insurance

Call your insurance company to confirm St Marys Good Samaritan Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72148.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Marys Good Samaritan Hospital

Compare: MRI, lower back (no contrast) at other GA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.