CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $308
  • Cash Discount Price: $3,633
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at HSHS St Elizabeth's Hospital is $308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,633. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.26x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$3,633

Average discount available for prompt cash payment at this facility.

Insurance Median
$308

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: $3,633 (1490%)
Insurance Median: $308 (126%)
Cash: $3,633 (1490% of Medicare)
Ins. Median: $308 (126% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $101 - $3,552 41%
Blue Cross Blue Shield $101 - $5,046 41%
Claim Doc $101 - $675 41%
Clear Spring Health Of Illinois $101 - $270 41%
Health Alliance Medical Plans $101 - $4,289 41%
Health Partners $101 - $270 41%
Hopetrust $101 - $648 41%
Humana $101 - $270 41%
Molina Healthcare $101 - $282 41%
Naphcare $101 - $585 41%
Sae Hospice $101 - $270 41%
UnitedHealthcare $101 - $5,046 41%
Meridian Health Plan $115 - $230 47%
Celtic Insurance Company $270 - $539 111%
Amish Community $1,413 580%
Cigna $2,862 - $5,046 1174%
Wellfirst $3,249 1333%
First Health $3,754 1540%
Healthlink $4,012 - $5,046 1646%
Caterpillar, Inc. $4,052 1662%
Consociate Group $4,440 1821%
Choicecare $4,541 1863%
Healthcare Finest Network (Hfn) $4,541 1863%
Multiplan/Phcs $4,541 1863%
Provider Network Of America $4,541 1863%
City Of Springfield $5,046 2070%
Current Health Solutions $5,046 2070%
Healthscope $5,046 2070%
Illinois Breast And Cervical Cancer Program $5,046 2070%
Interplan $5,046 2070%
Live360 $5,046 2070%
Wexford $5,046 2070%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals