CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Virginia Gay Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,121
Cash Discount Price: $1,856
vs. Medicare Baseline: 4.60x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Virginia Gay Hospital is $1,121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,856. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.60x the Medicare baseline. Located in 502 North 9Th Avenue, Vinton, IA.

Cash / Self-Pay

$1,856

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,121

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: $1,856 (761%)

Insurance Median: $1,121 (460%)

Cash: $1,856 (761% of Medicare)

Ins. Median: $1,121 (460% 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 460% of the Medicare baseline (a markup of 360%). 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
Aetna	$216	89%
Medicaid / KanCare	$244 - $1,008	100%
UnitedHealthcare	$777 - $1,120	319%
Va Ccn-All Plans	$845 - $871	347%
Health Alliance Mcr Adv	$891 - $918	366%
Wellmark Hmo	$983	403%
Wellmark Ppo-All Other Plans	$1,082	444%
Medical Associates-All Plans	$1,714 - $1,766	703%
Cedar Valley Community Healthcare-All Plans	$1,799 - $1,854	738%
Humana	$1,828 - $1,883	750%
Health Partners-All Plans	$1,942 - $2,001	797%
Healthsmart-All Plans	$1,942 - $2,001	797%
Corvel-All Plans	$2,125 - $2,189	872%
Health Alliance-All Other Plans	$2,171 - $2,236	891%

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 $1,856.
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 Virginia Gay 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.