CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Valor Health

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,192
Cash Discount Price: $2,564
vs. Medicare Baseline: 8.99x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Valor Health is $2,192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,564. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.99x the Medicare baseline. Located in 1202 East Locust Street, Emmett, ID.

Cash / Self-Pay

$2,564

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,192

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: $2,564 (1052%)

Insurance Median: $2,192 (899%)

Cash: $2,564 (1052% of Medicare)

Ins. Median: $2,192 (899% 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 899% of the Medicare baseline (a markup of 799%). 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
Tricare	$1,094 - $1,367	449%
Aetna	$1,128 - $2,504	463%
Blue Cross Blue Shield	$1,128 - $2,939	463%
Blue Shield Mcr Adv	$1,128 - $1,409	463%
Humana	$1,128 - $2,939	463%
Molina Mcr Adv - All Plans	$1,128 - $1,409	463%
Regence Bs Triwest - All Plans	$1,128 - $1,409	463%
UnitedHealthcare	$1,128 - $2,771	463%
Pacificsource Mcr Adv	$1,184 - $1,480	486%
Cigna	$2,169 - $2,768	890%
Moda Health - All Plans	$2,280 - $2,849	935%
Pacificsource Comm - All Other Plans	$2,280 - $2,849	935%
Select Health Comm - All Other Plans	$2,280 - $2,849	935%
Blue Shield Comm - All Other Plans	$7,199 - $8,996	2953%

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 $2,564.
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 Valor Health 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.