CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Madison County Health Care System

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,265
  • Cash Discount Price: $2,787
  • vs. Medicare Baseline: 9.29x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Madison County Health Care System is $2,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,787. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.29x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$2,787

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,265

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: $2,787 (1143%)
Insurance Median: $2,265 (929%)
Cash: $2,787 (1143% of Medicare)
Ins. Median: $2,265 (929% 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 929% of the Medicare baseline (a markup of 829%). 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
Blue Cross Blue Shield $983 - $1,082 403%
Aetna $1,498 - $2,265 615%
Medical Associates Hp - All Plans $1,498 615%
Medigold-All Plans $1,498 615%
Tricare $1,498 615%
UnitedHealthcare $1,498 - $3,136 615%
American Hp Mcr Adv-All Plans $1,573 645%
Iowa Total Care Mcaid-All Plans $1,637 672%
Molina Mcaid/Chip -All Plans $1,695 695%
Amerigroup Mcaid-All Plans $1,736 712%
Madison County Sheriff-All Plans $1,742 715%
Oscar - All Plans $2,247 922%
Corvel Wc-All Plans $3,136 1286%
Choicecare-All Plans $3,310 1358%
First Choice-All Plans $3,310 1358%
First Health-All Plans $3,310 1358%
Integrated Hp-All Plans $3,310 1358%
Mutual Of Omaha-All Plans $3,310 1358%
Plaines Health-All Plans $3,310 1358%
Preferred Hlth Ntwork-All Plans $3,310 1358%
Principal Healthcare-All Plans $3,310 1358%
Usa Managed Care-All Plans $3,310 1358%
Medimore Employee Hp - All Plans $3,414 1401%
Midlands Choice - All Plans $3,414 1401%
Benefit Admin Of America-All Plans $3,484 1429%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals