CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Orange City Area Health System

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $581
Cash Discount Price: $1,004
vs. Medicare Baseline: 2.38x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Orange City Area Health System is $581. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,004. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.38x the Medicare baseline. Located in 1000 Lincoln Circle Se, Orange City, IA.

Cash / Self-Pay

$1,004

Average discount available for prompt cash payment at this facility.

Insurance Median

$581

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: $1,004 (412%)

Insurance Median: $581 (238%)

Cash: $1,004 (412% of Medicare)

Ins. Median: $581 (238% 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 238% of the Medicare baseline (a markup of 138%). 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
UnitedHealthcare	$88 - $2,038	36%
Avera-All Plans	$109 - $2,196	45%
Sanford Health-All Plans	$135 - $2,151	55%
Health Partners Coordinated-All Other Plans	$141 - $2,038	58%
Wellmark Hmo	$152 - $983	62%
Midlands Choice-All Plans	$154 - $2,038	63%
Health Partners Open	$156 - $2,038	64%
Wellmark Ppo - All Other Plans	$178 - $1,082	73%

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 $1,004.
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 Orange City Area Health System 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.