CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Fayette County Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $475
Cash Discount Price: $2,728
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Fayette County Hospital is $475. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,728. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.95x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$2,728

Average discount available for prompt cash payment at this facility.

Insurance Median

$475

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: $2,728 (1119%)

Insurance Median: $475 (195%)

Cash: $2,728 (1119% of Medicare)

Ins. Median: $475 (195% 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.

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
Health Alliance Mcare	$68 - $1,617	28%
Healthlink Mcr Adv	$68 - $1,617	28%
Aetna	$71 - $3,487	29%
Blue Cross Blue Shield	$71 - $4,245	29%
Illinicare - All Plans	$71 - $475	29%
Medicaid / KanCare	$71 - $475	29%
Meridian-All Plans	$71 - $475	29%
Cigna	$79 - $3,790	32%
Coventry/Ghp-All Plans	$92 - $3,285	38%
Multiplan - All Plans	$127 - $4,296	52%
Health Alliance - All Other Plans	$137 - $4,175	56%
UnitedHealthcare	$334 - $4,195	137%
Healthlink Hmo	$346 - $3,538	142%
Healthlink Ppo - All Other Plans	$346 - $4,043	142%
Humana	$1,617	663%

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 $2,728.
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 Fayette County 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.