CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,507
Cash Discount Price: $3,658
vs. Medicare Baseline: 10.28x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Children's Healthcare of Atlanta at Scottish Rite is $2,507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,658. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.28x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$3,658

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,507

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: $3,658 (1501%)

Insurance Median: $2,507 (1028%)

Cash: $3,658 (1501% of Medicare)

Ins. Median: $2,507 (1028% 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 1028% of the Medicare baseline (a markup of 928%). 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
Peachstate [43]	$1,529	627%
Caresource [61]	$1,571	644%
Amerigroup [102]	$1,587	651%
Cigna	$2,418	992%
Blue Cross Blue Shield	$2,427 - $3,571	996%
United [5]	$2,427	996%
Ambetter / Centene	$2,449	1005%
Oscar [228]	$2,451	1005%
Aetna	$2,462	1010%
Caresource Marketplace Bronze/Silver/Gold [60]	$2,486	1020%
Kaiser [6]	$2,491	1022%
Sidecar Health [236]	$2,524	1035%
Direct Employer Agreements [72]	$2,561 - $3,109	1051%
Coventry [9]	$2,567	1053%
Northeast Georgia Heatlh System [808]	$2,744	1126%
Veracity Benefits [809]	$2,744	1126%
First Health [74]	$2,746	1126%
Phcs [93]	$3,109	1275%
Secure Health [340]	$3,109	1275%
Beech Street [71]	$3,292	1350%
Multiplan [92]	$3,585	1471%
Novanet [41]	$3,658	1501%

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 $3,658.
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 Children's Healthcare of Atlanta at Scottish Rite 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.