CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,528
Cash Discount Price: $1,918
vs. Medicare Baseline: 6.27x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sarah D Culbertson Memorial Hospital is $1,528. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,918. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.27x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$1,918

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,528

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: $1,918 (787%)

Insurance Median: $1,528 (627%)

Cash: $1,918 (787% of Medicare)

Ins. Median: $1,528 (627% 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 627% of the Medicare baseline (a markup of 527%). 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	$68 - $3,198	28%
Blue Cross Blue Shield	$68 - $3,482	28%
Molina Mmai-All Other Plans	$68 - $1,528	28%
UnitedHealthcare	$68 - $3,198	28%
Meridian Hp Mcaid-All Plans	$71 - $788	29%
Molina Healthcare Mcaid	$71 - $788	29%
Cigna	$82 - $2,626	34%
Multiplan/Phcs-All Plans	$205 - $3,198	84%
Health Dynamics-All Plans	$568 - $3,198	233%
Preferred Medical Claims Solution-All Plans	$639 - $3,198	262%
Three Rivers Provider Network-All Plans	$639 - $3,198	262%
Corvel-All Plans	$788	323%
Humana	$1,528	627%
Beech Street-All Plans	$3,198	1312%
Encompass-All Plans	$3,198	1312%
Healthlink-All Plans	$3,198	1312%
Hfn Epo	$3,198	1312%
Hfn Ppo Ip/Op Only-All Other Plans	$3,198	1312%
Wexford Ip/Op Only-All Plans	$3,198	1312%
Healthsmart-All Plans	$3,375	1385%

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 $1,918.
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 Sarah D Culbertson Memorial 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.