CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Franklin General Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,333
Cash Discount Price: $2,841
vs. Medicare Baseline: 5.47x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Franklin General Hospital is $1,333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,841. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.47x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$2,841

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,333

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: $2,841 (1165%)

Insurance Median: $1,333 (547%)

Cash: $2,841 (1165% of Medicare)

Ins. Median: $1,333 (547% 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 547% of the Medicare baseline (a markup of 447%). 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
Wellmark Hmo	$983	403%
Wellmark Ppo - All Other Plans	$1,082	444%
Medical Associates Mcare	$1,263	518%
Mount Carmel Hp-All Plans	$1,263	518%
Tricare	$1,263	518%
UnitedHealthcare	$1,263 - $2,623	518%
Amerigroup Mcare	$1,275	523%
Wellmark Mcr Adv	$1,275	523%
Molina Mcare	$1,313	539%
Ambetter / Centene	$1,320 - $2,020	541%
American Hp Iowa - All Plans	$1,326	544%
Amerigroup Mcaid - All Other Plans	$1,333	547%
Molina Mcaid - All Other Plans	$1,340	550%
Centivo - All Plans	$1,894	777%
Medical Ass Hosp Employer Group	$1,894	777%
Oscar - All Plans	$1,894	777%
Midlands Choice-All Plans	$2,210	907%
Medical Associates Hp-All Other Plans	$2,683	1101%
Preferred Health Choices-All Plans	$2,683	1101%
Splashlight Llc-All Plans	$2,683	1101%
Aetna	$2,936 - $2,999	1204%
Multiplan-All Plans	$2,999	1230%

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 $2,841.
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 Franklin General Hospital 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.