CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Spencer Municipal Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $1,400
  • Cash Discount Price: $1,235
  • vs. Medicare Baseline: 5.74x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Spencer Municipal Hospital is $1,400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,235. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.74x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$1,235

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,400

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: $1,235 (507%)
Insurance Median: $1,400 (574%)
Cash: $1,235 (507% of Medicare)
Ins. Median: $1,400 (574% 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 574% of the Medicare baseline (a markup of 474%). 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
Medicare (plans) $203 - $205 83%
UnitedHealthcare $203 - $1,482 83%
Humana $205 - $1,564 84%
Medicaid / KanCare $228 94%
Wellmark Hmo $806 331%
Wellmark Ppo $885 363%
Healthpartners (All) $1,317 540%
Midlands Choice - Ilcc $1,400 574%
Midlands Choice - Morton Bldg $1,400 574%
Coventry - Commercial Hmo $1,482 608%
Avera Health Plan $1,564 642%
Coventry - Commercial Ppo $1,564 642%
First Choice Of Midwest $1,564 642%
Midlands Choice (All Others) $1,564 642%
Sanford Health $1,564 642%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals