CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Illini Community Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $5,706
Cash Discount Price: $4,028
vs. Medicare Baseline: 23.41x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Illini Community Hospital is $5,706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,028. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 23.41x the Medicare baseline. Located in 640 W Washington, Pittsfield, IL.

Cash / Self-Pay

$4,028

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,706

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: $4,028 (1652%)

Insurance Median: $5,706 (2341%)

Cash: $4,028 (1652% of Medicare)

Ins. Median: $5,706 (2341% 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 2341% of the Medicare baseline (a markup of 2241%). 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
Humana	$1,966	806%
Blue Cross Blue Shield	$3,457 - $5,706	1418%
Blue Access	$4,028	1652%
United Behavioral Health	$4,028	1652%
UnitedHealthcare	$5,371	2203%
Aetna	$5,706	2341%
Blue Preferred	$5,706	2341%
Cigna	$5,706	2341%
Health Link	$5,706	2341%
Private Healthcare Systems-Multi Plan Primary	$5,706	2341%
Health Link Ppo	$6,042	2479%
Private Healthcare Systems-Multi Plan Complementary	$6,042	2479%

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 $4,028.
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 Illini Community 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.