CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,093
Cash Discount Price: $832
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Clearwater Valley Hospital & Clinics is $1,093. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $832. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.48x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.

Cash / Self-Pay

$832

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,093

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: $832 (341%)

Insurance Median: $1,093 (448%)

Cash: $832 (341% of Medicare)

Ins. Median: $1,093 (448% 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 448% of the Medicare baseline (a markup of 348%). 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
Cigna	$59 - $1,822	24%
Humana	$66 - $1,963	27%
Nimiipuu Mcr Adv-All Plans	$66 - $1,104	27%
Regence Blue Shield Mcr	$66 - $1,093	27%
Veterans Amin-All Plans	$66 - $1,093	27%
Pacific Source - All Plans	$68 - $1,093	28%
Blue Cross Blue Shield	$76 - $1,521	31%
Aetna	$105 - $1,882	43%
UnitedHealthcare	$124	51%
Idaho Phys Network-All Plans	$185 - $1,923	76%
Multiplan / Phcs-All Plans	$187 - $1,963	77%
Geha-All Plans	$189 - $1,984	78%
First Choice-All Plans	$191 - $1,984	78%
Corizon Correctnal Med-All Plans	$195 - $1,478	80%
Regence Blue Shield-All Other Plans	$2,024	830%

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 $832.
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 Clearwater Valley Hospital & Clinics 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.