CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Saint Joseph Regional Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $974
  • Cash Discount Price: $3,026
  • vs. Medicare Baseline: 4.00x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Saint Joseph Regional Medical Center is $974. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,026. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.00x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$3,026

Average discount available for prompt cash payment at this facility.

Insurance Median
$974

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: $3,026 (1241%)
Insurance Median: $974 (400%)
Cash: $3,026 (1241% of Medicare)
Ins. Median: $974 (400% 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 400% of the Medicare baseline (a markup of 300%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $112 - $891 46%
Aetna $131 - $3,026 54%
Medicaid / KanCare $131 - $458 54%
UnitedHealthcare $131 - $1,508 54%
Geha $204 - $1,056 84%
Healthscope $204 - $1,056 84%
Student Insurance Cma $204 - $1,056 84%
Medicare (plans) $252 - $257 103%
Meridian Complete $252 103%
Pace-Trinity Health $252 103%
County Coroner $263 108%
Provider Partners Health Plan Of Indiana $278 114%
Auxiant $379 - $3,864 155%
Physicians Health Plan Northern Indiana Health Insurance $379 - $762 155%
St Joseph County Hlth Dpt $379 155%
Caresource $391 160%
Siho Insurance Services $404 166%
Key Benefit Administrator $454 - $2,896 186%
Managed Health Services - Indiana $458 188%
Mdwise $458 188%
Allied Benefit Systems $480 - $3,026 197%
Custom Design Benefits $543 223%
Blue Benefit Administrators Of Massachusetts $891 366%
Blue Care Network $891 366%
Blue Distinction Transplant $891 366%
Blue Shield - Ca $891 366%
Blue Shield - Id (Regence) $891 366%
Blue Shield - Ny Highmark Northeastern $891 366%
Blue Shield - Ny Highmark Western $891 366%
Blue Shield - Pa (Highmark) $891 366%
Blue Shield - Wa (Regence) $891 366%
Asr Health Benefits $974 - $3,026 400%
Christian Brother Services $974 - $3,026 400%
Employee Benefit Management $974 - $3,026 400%
Medical Mutual $974 - $3,026 400%
Meritain $974 - $3,026 400%
Preferred One $974 - $3,026 400%
Rural Carrier Health Benefit Plan $974 - $3,026 400%
Webtpa $974 - $3,026 400%
Hospice Of Marshall County $1,210 496%
Hospice Of St Joseph County $1,210 496%
Plain Church Group $1,257 516%
Notre Dame Athletic Association $2,560 1050%
Wc Notre Dame $2,560 1050%
Luminare Health (Detroit) $2,653 - $2,793 1088%
Encore Health $2,759 - $2,896 1132%
Ameriben $2,793 1146%
Indiana Criminal Justice Inst $2,896 1188%
Western & Southern Financial Group $2,896 1188%
Cigna $2,979 1222%
Group Administrators $2,979 1222%
Health Partners $2,979 1222%
Mvp $2,979 1222%
Prairie States $2,979 1222%
Priority Health $2,979 1222%
Professional Benefit Administrators $2,979 1222%
Sagamore Health Network $2,979 - $3,445 1222%
Sisco Benefits $2,979 1222%
Unified Group Services $2,979 1222%
Goshen Preferred Network $3,584 - $4,003 1470%
Christian Brothers Holy Cross $3,724 1528%
Signature Care $3,724 1528%
Bankers Life Casualty $4,655 1910%
Bureau Of Disability $4,655 1910%
Wc Align Network $4,655 1910%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals