CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Elkhart General Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,219
Cash Discount Price: $1,321
vs. Medicare Baseline: 5.00x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Elkhart General Hospital is $1,219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,321. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.00x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$1,321

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,219

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: $1,321 (542%)

Insurance Median: $1,219 (500%)

Cash: $1,321 (542% of Medicare)

Ins. Median: $1,219 (500% 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 500% of the Medicare baseline (a markup of 400%). 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
Mclaren (Mi	$136	56%
UnitedHealthcare	$136 - $1,366	56%
Aetna	$253 - $1,376	104%
Blue Cross Blue Shield	$253 - $755	104%
Humana	$253 - $1,422	104%
Pace	$253	104%
Devoted Healthcare	$266 - $406	109%
Plain Church	$380 - $1,626	156%
Caresource	$405 - $2,642	166%
Mhs	$456 - $2,642	187%
Mdwise	$458 - $2,642	188%
Cha	$1,219 - $1,585	500%
Immergrun	$1,219 - $1,626	500%
Php	$1,321 - $1,422	542%
Cigna	$1,463 - $1,544	600%
Multiplan	$1,463	600%
Signature	$1,483	608%
Encore	$1,504	617%
Heartland	$2,032	834%

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 $1,321.
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 Elkhart General 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.