CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Advocate Good Samaritan Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,556
Cash Discount Price: $1,505
vs. Medicare Baseline: 6.38x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Advocate Good Samaritan Hospital is $1,556. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,505. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.38x the Medicare baseline. Located in 3815 Highland Avenue, Downers Grove, IL.

Cash / Self-Pay

$1,505

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,556

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: $1,505 (617%)

Insurance Median: $1,556 (638%)

Cash: $1,505 (617% of Medicare)

Ins. Median: $1,556 (638% 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 638% of the Medicare baseline (a markup of 538%). 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
Ambetter / Centene	$365	150%
Molina	$365	150%
Oscar Health Hmo	$378	155%
Hstechnology	$484	199%
Cigna	$1,096	450%
Advocate Employee	$1,186 - $1,315	487%
UnitedHealthcare	$1,276	523%
Blue Cross Blue Shield	$1,556 - $2,372	638%
Aetna	$1,613	662%
Private Healthcare Systems	$1,866 - $2,408	765%
Multiplan	$2,408	988%

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 $1,505.
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 Advocate Good Samaritan Hospital 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.