CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Warner Hospital and Health Services

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,458
Cash Discount Price: $4,434
vs. Medicare Baseline: 14.19x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Warner Hospital and Health Services is $3,458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,434. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.19x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$4,434

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,458

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: $4,434 (1819%)

Insurance Median: $3,458 (1419%)

Cash: $4,434 (1819% of Medicare)

Ins. Median: $3,458 (1419% 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 1419% of the Medicare baseline (a markup of 1319%). 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
Aetna	$915 - $3,769	375%
Blue Cross Blue Shield	$915 - $4,345	375%
Harmony Hp Mcaid-All Plans	$915	375%
Medicaid / KanCare	$915	375%
Meridian Hp-All Plans	$915	375%
Molina-All Other Plans	$915	375%
Health Alliance Med Adv	$1,818	746%
Humana	$1,818 - $3,769	746%
Molina Mcr/Mcd Dual	$1,818	746%
UnitedHealthcare	$1,818 - $3,769	746%
Wellcare Mcr Adv-All Plans	$1,818	746%
Healthlink Hmo	$3,458	1419%
City Of Clinton (Employees Serv)-All Plans	$3,547	1455%
Cigna	$3,680	1510%
Caterpillar-All Plans	$3,769	1546%
Multiplan Phcs-All Plans	$3,769	1546%
Health Alliance-All Other Plans	$3,902	1601%
Healthlink Ppo/Work Comp-All Other Plans	$3,902	1601%
Consociate Care Ppo-All Plans	$3,990	1637%
Hfn Ppo/Epo-All Plans	$3,990	1637%
Three Rivers-All Plans	$4,212	1728%

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 $4,434.
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 Warner Hospital and Health Services 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.