CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: West Valley Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $717
Cash Discount Price: $1,535
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at West Valley Medical Center is $717. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,535. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.94x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$1,535

Average discount available for prompt cash payment at this facility.

Insurance Median

$717

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: $1,535 (630%)

Insurance Median: $717 (294%)

Cash: $1,535 (630% of Medicare)

Ins. Median: $717 (294% 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 294% of the Medicare baseline (a markup of 194%). 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
Blue Cross Blue Shield	$56 - $2,172	23%
Molina	$56 - $94	23%
Select Health Idaho (Eirmc Only)	$250 - $729	103%
Corizon Health	$290 - $846	119%
True Blue	$309 - $903	127%
Cigna	$439 - $1,280	180%
Pacificsource Health	$468 - $1,365	192%
United	$468 - $1,365	192%
Moda	$488 - $1,425	200%
Regence	$488	200%
St Luke'S Health Partners	$509 - $1,486	209%
Aetna	$620 - $1,809	254%
Four Rivers Hospice	$627 - $1,829	257%
Multiplan	$627 - $1,829	257%
Humana	$658 - $1,921	270%
Geha Ppo Usa	$666 - $1,944	273%
Coventry First Health	$705 - $2,058	289%
St Alphonsus Health	$705 - $2,058	289%

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 $1,535.
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 West Valley Medical Center 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.