CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health Castle

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,541
Cash Discount Price: $678
vs. Medicare Baseline: 6.32x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health Castle is $1,541. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $678. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.32x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$678

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,541

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: $678 (278%)

Insurance Median: $1,541 (632%)

Cash: $678 (278% of Medicare)

Ins. Median: $1,541 (632% 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 632% of the Medicare baseline (a markup of 532%). 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
Kfh Mcr Adv	$282	116%
Medicare (plans)	$282	116%
Ohana Health Plan - All Plans	$288	118%
Devoted Hlth Mcr Adv - All Plans	$296	121%
UnitedHealthcare	$440	180%
Alohacare Quest Mcaid - All Other Plans	$454 - $605	186%
Hmsa Hmo	$818	336%
Hmsa Ppo - All Other Plans	$818	336%
Pacific Admin Ppo - All Plans	$1,156 - $1,541	474%
Hwmg/Hmaa - All Plans	$1,337 - $1,783	548%
Mdx Hawaii Ppo - All Plans	$1,451 - $1,934	595%
Health Alliance - All Plans	$1,454 - $1,938	596%
Kfh - All Other Plans	$1,544 - $2,060	633%
Uni Health Alliance - All Plans	$1,695 - $2,261	695%
First Health Ppo - All Plans	$1,708 - $2,278	701%
Medicaid / KanCare	$1,817 - $2,423	745%
State Of Hi Nonprofit - All Plans	$3,180 - $4,240	1305%

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 $678.
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 Adventist Health Castle 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.