CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Mercyone Clinton Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $525
  • Cash Discount Price: $2,599
  • vs. Medicare Baseline: 2.15x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Mercyone Clinton Medical Center is $525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,599. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.15x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$2,599

Average discount available for prompt cash payment at this facility.

Insurance Median
$525

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: $2,599 (1066%)
Insurance Median: $525 (215%)
Cash: $2,599 (1066% of Medicare)
Ins. Median: $525 (215% 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 215% of the Medicare baseline (a markup of 115%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Iowa Total Care $220 90%
Medicaid / KanCare $222 - $223 91%
Bcn Domestic $244 100%
Blue Benefit Administrators Of Massachusetts $244 100%
Blue Care Network $244 100%
Blue Cross Blue Shield $244 - $251 100%
Blue Distinction Transplant $244 100%
Blue Shield - Ca $244 100%
Blue Shield - Id (Regence) $244 100%
Blue Shield - Ny Highmark Northeastern $244 100%
Blue Shield - Ny Highmark Western $244 100%
Blue Shield - Pa (Highmark) $244 100%
Blue Shield - Wa (Regence) $244 100%
Kaiser Domestic $244 100%
Pre-Employment $244 100%
Wc Domestic $244 100%
Aetna $249 - $3,498 102%
Medicare (plans) $249 - $259 102%
UnitedHealthcare $254 - $3,998 104%
Amish Hospital Aid $338 139%
Oscar $347 142%
Ambetter / Centene $427 175%
Claimdoc $511 210%
Nova $511 210%
Geha $525 215%
Health Choices $1,131 464%
Medical Associates $1,131 464%
Preferred Health Choice $1,155 474%
The Alliance $2,425 995%
1199 National Benefit Fund $3,498 1435%
Allied Benefit Systems $3,498 1435%
Asr Health Benefits $3,498 1435%
Christian Brother Services $3,498 1435%
Coventry $3,498 1435%
First Health $3,498 1435%
Lucent Health $3,498 1435%
Luminare Health $3,498 1435%
Medical Mutual $3,498 1435%
Meritain $3,498 1435%
Trustmark Small Business Benefits $3,498 1435%
Webtpa $3,498 1435%
Health Partners $3,506 1438%
Auxiant $3,598 1476%
Cigna $3,598 1476%
Medica $3,598 1476%
Midlands $3,598 1476%
Midlands Choice $3,598 1476%
Multiplan $3,598 1476%
Qualcare $3,598 1476%
Usa Managed Care $3,798 1558%
Crime Victim Assistance $3,998 1640%
Iowa Dept Of Public Health $3,998 1640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals